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Preventing vent acquired pneumonia (VAP) in the icu - Essay Example

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Ventilator-associated pneumonia or VAP is one of the challenging complications in intensive care units and contributes to significant health care costs, morbidity and mortality. Hence, it is very important to prevent ventilator-associated pneumonia to optimize patient outcomes…
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Preventing vent acquired pneumonia (VAP) in the icu
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Preventing vent acquired pneumonia (VAP) in the icu

Microbiological surveillance is important because it prevents emergence of multi-drug resistant bacteria and also in determining empirical therapy for patients with VAP. According to Babcock et al (2004), educating health professionals about prevention of VAP is critical for prevention of not only VAP, but also various nosocomial infections. Similar reports were delivered by Needleman et al (2002) and Cho et al (2003).
Another important strategy for prevention of VAP is early extubation and this is possible by following certain extubation protocols like interruption of sedation every day. According to Cook et al (2000), decreased time of mechanical ventilation decreases the risk of aspiration and consequently decreases VAP risk.
The third strategy useful to prevent VAP is prevention of aspiration. Nieuwenhoven et al (2006) have reported that evevation of bed at 45 degrees prevents aspiration. Timely drainage of secretions in the subglottic region which get contaminated easily (Bonten et al. 2004), avoiding manipulation of fluids in the ventilator circuits (Han and Liu, 2010) and use appropriate endotracheal cuff pressure (Valencia et al. 2007) also prevent aspiration of contaminated fluids and secretions.
There are several decontamination strategies which have been advocated for prevention of VAP. Some drugs like chlorhexidine are useful for oral decontamination. Selective decontamination of the intestines is possible by using antibiotics like polymyxin which are non-absorbable (Bonten and Krueger, 2006).
Babcock, H.M., Zack, J.E., Garrison, T., Trovillion, E., Jones, M., Fraser, V.J. et al. (2004) An educational intervention to reduce ventilator-associated pneumonia in an integrated health system: a comparison of effects. Chest, 125, 2224–2231.
Tablan, O.C., Anderson, L.J., Besser, R., Bridges, C. and Hajjeh, R. (2004) Guidelines for preventing health-care–associated pneumonia, 2003: ... Read More
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