File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Practical strategies in the prevention of ventilator-associated pneumonia

TitlePractical strategies in the prevention of ventilator-associated pneumonia
Authors
KeywordsPractical Prevention
Ventilator-Associated Pneumonia
Issue Date1997
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.clinpulm.com
Citation
Clinical Pulmonary Medicine, 1997, v. 4 n. 3, p. 135-140 How to Cite?
AbstractIntubation and mechanical ventilation are associated with a 4- to 21- fold increase in pneumonia, which occurs in 10% to 65% of patients on mechanical ventilation, depending on the population studied. Patients on mechanical ventilation are at particular risk of pneumonia because of various factors that impair host defense and/or increase exposure to microorganisms. Preventive strategies should target risk factors that are important in the pathogenesis of ventilator-associated pneumonia. Effective and practical measures include the following: (1) infection control measures- the importance of simple measures in the prevention and spread of nosocomial infection cannot be overemphasized: proper hand washing between handling of patients; changing of ventilator circuits no more than every 48 hours; aseptic techniques in instrumentation including tracheal suction; careful drainage of tubing condensate; proper disinfection of ventilator circuits, nebulizers, resuscitation bags, and other equipment; isolation of patients infected with resistant/highly infectious organisms with the use of disposable gloves and gowns, and, where available, isolation rooms; additional isolation measures in relevant cases such as air filters for aspergillosis in high-risk patients; prompt detection of infectious reservoirs through a bacterial surveillance program and institution of relevant control measures; (2) prevention of aspiration by adoption of semierect position and careful oropharyngeal suction to decrease the amount of secretions pooling above the inflated cuff; (3) prevention of gastric colonization by careful choice of stress ulcer prophylaxis; enteral feeding with orogastric and nasogastric routes of tube placement, use of small-bore tube if there is no requirement for larger size, and avoidance of large- volume feeds with rate adjustment according to any evidence of retention; (4) enhancement of host-clearance mechanisms by proper pain control, chest physiotherapy, breathing exercises, frequent turning for postural drainage, and early ambulation; (5) prevention of bacterial colonization by pathogenic bacteria by judicious use of antibiotics, preferably propagated through a hospital policy; and (6) expedient removal of invasive instrumentation when no longer needed.
Persistent Identifierhttp://hdl.handle.net/10722/162186
ISSN
2015 SCImago Journal Rankings: 0.178
References

 

DC FieldValueLanguage
dc.contributor.authorIp, Men_US
dc.date.accessioned2012-09-05T05:17:53Z-
dc.date.available2012-09-05T05:17:53Z-
dc.date.issued1997en_US
dc.identifier.citationClinical Pulmonary Medicine, 1997, v. 4 n. 3, p. 135-140en_US
dc.identifier.issn1068-0640en_US
dc.identifier.urihttp://hdl.handle.net/10722/162186-
dc.description.abstractIntubation and mechanical ventilation are associated with a 4- to 21- fold increase in pneumonia, which occurs in 10% to 65% of patients on mechanical ventilation, depending on the population studied. Patients on mechanical ventilation are at particular risk of pneumonia because of various factors that impair host defense and/or increase exposure to microorganisms. Preventive strategies should target risk factors that are important in the pathogenesis of ventilator-associated pneumonia. Effective and practical measures include the following: (1) infection control measures- the importance of simple measures in the prevention and spread of nosocomial infection cannot be overemphasized: proper hand washing between handling of patients; changing of ventilator circuits no more than every 48 hours; aseptic techniques in instrumentation including tracheal suction; careful drainage of tubing condensate; proper disinfection of ventilator circuits, nebulizers, resuscitation bags, and other equipment; isolation of patients infected with resistant/highly infectious organisms with the use of disposable gloves and gowns, and, where available, isolation rooms; additional isolation measures in relevant cases such as air filters for aspergillosis in high-risk patients; prompt detection of infectious reservoirs through a bacterial surveillance program and institution of relevant control measures; (2) prevention of aspiration by adoption of semierect position and careful oropharyngeal suction to decrease the amount of secretions pooling above the inflated cuff; (3) prevention of gastric colonization by careful choice of stress ulcer prophylaxis; enteral feeding with orogastric and nasogastric routes of tube placement, use of small-bore tube if there is no requirement for larger size, and avoidance of large- volume feeds with rate adjustment according to any evidence of retention; (4) enhancement of host-clearance mechanisms by proper pain control, chest physiotherapy, breathing exercises, frequent turning for postural drainage, and early ambulation; (5) prevention of bacterial colonization by pathogenic bacteria by judicious use of antibiotics, preferably propagated through a hospital policy; and (6) expedient removal of invasive instrumentation when no longer needed.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.clinpulm.comen_US
dc.relation.ispartofClinical Pulmonary Medicineen_US
dc.subjectPractical Preventionen_US
dc.subjectVentilator-Associated Pneumoniaen_US
dc.titlePractical strategies in the prevention of ventilator-associated pneumoniaen_US
dc.typeArticleen_US
dc.identifier.emailIp, M:msmip@hku.hken_US
dc.identifier.authorityIp, M=rp00347en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-0030874696en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030874696&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume4en_US
dc.identifier.issue3en_US
dc.identifier.spage135en_US
dc.identifier.epage140en_US
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridIp, M=7102423259en_US

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats