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Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination

Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination

Ventilator-associated pneumonia (VAP) remains a serious complication of mechanical ventilation (MV), and has an incidence between 2 and 16 episodes per 1000 ventilator-days, an attributable mortality of 5–13%, excess ICU length of stay (LOS) for survivors up to 9 days, and extra costs. Many studies have reported decreased VAP rates associated with the use of bundles of preventive measures. Fewer studies have reported compliance with preventive measures and explored sustainability of interventions after implementation. Except for one, studies have not reported results of a bundle including selective oropharyngeal decontamination (SOD). Simple preventive measures including SOD, surveillance and feedback, and education can significantly decrease VAP rates, duration of MV, and mortality. However, long-term use of SOD implies continuous surveillance of the emergence and selection of antimicrobial resistance.

CriticalCare.news
November 26, 2018