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Non-Pharmacologic Measures to Prevent VAP
- Ventilator-associated pneumonia (VAP) is one of the most common complications of mechanical ventilation and is associated with significant increases in morbidity and mortality.
- With the persistence of the boarding crisis, many critically ill intubated patients remain in EDs for extended periods of time, thereby increasing their length of stay, morbidity, and mortality.
- For the critically ill intubated patient, consider implementing the following non-pharmacologic interventions that have been shown to decrease the incidence of VAP:
- Strict hand hygiene compliance
- Elevating the head of the bed to 45 degrees, unless contraindicated
- Utilize endotracheal tubes with subglottic secretion drainage
- The following interventions have not been consistently shown to reduce VAP:
- Continuous endotracheal cuff monitoring
- Closed endotracheal suctioning systems
- Silver-coated endotracheal tubes
References
Krone M, Seeber C, Nydahl P. What's New in Intensive Care: Preventing Ventilator-Associated Pneumonia Non-Pharmacologically. Intensive Care Med. 2024; 50:2185-2187.