Ventilator-Associated Events and Their Prevention.
The Centers for Disease Control and Prevention shifted the focus of safety surveillance in mechanically ventilated patients from ventilator-associated pneumonia to ventilator-associated events (VAEs) in 2013. The shift was designed to increase the objectivity and reproducibility of surveillance and to encourage quality-improvement programs to tackle a broader array of complications in mechanically ventilated patients. Prospective intervention studies have found that minimizing sedation, increasing the use of spontaneous awakening and breathing trials, and conservative fluid management can lower VAE rates and decrease duration of mechanical ventilation. Additional strategies to prevent VAEs include early mobility programs, low tidal volume ventilation, and restrictive transfusion thresholds.
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, 401 Park Street, Suite 401, Boston, MA 02215, USA.
Noelle M
NM
Cocoros
Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, 401 Park Street, Suite 401, Boston, MA 02215, USA; Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: mklompas@partners.org.
Michael
M
Klompas
D003428:Cross Infection; D006801:Humans; D053717:Pneumonia, Ventilator-Associated; D011654:Pulmonary Edema; D012121:Respiration, Artificial / Q000009:adverse effects*; D055397:Ventilator-Induced Lung Injury
Infection control; Mechanical ventilation; Prevention; Quality improvement; Ventilator-associated events; Ventilator-associated pneumonia