title: Strategies for prevention of ventilator-associated pneumonia: bundles, devices, and medications for improved patient outcomes.
abstract: Ventilator-associated pneumonia is associated with significant patient morbidity, mortality, and increased health care costs. In the current economic climate, it is crucial to implement cost-effective prevention strategies that have proven efficacy. Multiple prevention measures have been proposed by various expert panels. Global strategies have focused on infection control, and reduction of lower airway colonization with bacterial pathogens, intubation, duration of mechanical ventilation, and length of stay in the intensive care unit. Routine use of the Institute for Healthcare Improvement ventilator care bundle is widespread, and has been clearly demonstrated to be an effective method for reducing the incidence of ventilator-associated pneumonia. In this article, we examine specific aspects of the Institute for Healthcare Improvement bundle, better-designed endotracheal tubes, use of antibiotics and probiotics, and treatment of ventilator-associated tracheobronchitis to prevent ventilator-associated pneumonia.
authors.affiliation: Department of General Internal Medicine, Lahey Clinic Medical Center, Burlington, MA 01805, USA.
authors.forename: Fahad
authors.initials: F
authors.lastname: Alroumi
authors.forename: Akmal
authors.initials: A
authors.lastname: Sarwar
authors.forename: Philip E
authors.initials: PE
authors.lastname: Grgurich
authors.forename: Yuxiu
authors.initials: Y
authors.lastname: Lei
authors.forename: Jana
authors.initials: J
authors.lastname: Hudcova
authors.forename: Donald E
authors.initials: DE
authors.lastname: Craven
mesh_terms: D002710:Chlorhexidine / Q000008:administration & dosage; D003362:Cost-Benefit Analysis; D004202:Disinfectants / Q000008:administration & dosage; D004322:Drainage / Q000379:methods; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D006235:Hand Disinfection / Q000379:methods; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007318:Inservice Training; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D009910:Oral Hygiene / Q000379:methods; D056888:Patient Positioning / Q000379:methods; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy / Q000191:economics / Q000517:prevention & control*; D019936:Probiotics / Q000008:administration & dosage; D058616:Synbiotics; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000379:methods
chemical_list: D004202:Disinfectants; D005765:Gastrointestinal Agents; D002710:Chlorhexidine