title: [Update. Consensus on ventilator associated pneumonia. Second Part: Prophylaxis].
abstract: Ventilator associated pneumonia is a life threatening disease, in spite of advances in its treatment, consequently the development of prevention strategies is a key factor in improving the morbidity and mortality in intensive care units (ICU). The new developments in this field in the last years led to the need to update the recommendations done in 2001. Then, a new search and analysis of scientific literature was performed. The obtained data support different strategies highlighting: semi-recumbent position at 45 degrees of patients; incorporation of routinely oral hygiene procedures with chlorhexidine; preference of orotracheal intubation; performing subglotic aspiration; use of standard hand hygiene techniques; not routine change of ventilator circuits; and defining bundles to organize the work at ICU. Some strategies were recommended for being of similar efficacy to others but cost-effective as: use of heat and moisture humidificators; and changing humidificators every 5 to 7 days. The use of open or closed endotracheal suctioning system does not affect the incidence of pneumonia. Some recommendations were not incorporated because of lack of evidence supporting effectiveness, controversial data or doubtful application to our country as selective digestive decontamination.
authors: Universidad Austral de Chile, Valdivia (MCA). macalvo@uach.cl
authors: Mario
authors: M
authors: Calvo
authors: Luis
authors: L
authors: Delpiano
authors: Eliana
authors: E
authors: Chacón
authors: Irene
authors: I
authors: Jemenao
authors: Anamaría
authors: A
authors: Peña
authors: Alejandra
authors: A
authors: Zambrano
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D007362:Intensive Care Units; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*