In one study, 42 the duration of mechanical ventilation, hospital and intensive care unit lengths of stay, and mortality decreased when an outcome manager was used. However, a trial by Singh and colleagues [ 26 ] demonstrated that the CPIS is an effective clinical tool for determining whether to stop or continue antibiotics for longer than 3 days.
N Engl J Med 2013, 355: Year in review 2011: As ICU patients are a heterogeneous group of patients with multiple factors affecting their individual outcome, it is often difficult to show an outcome benefit from a single intervention. The prevention of ventilator-associated pneumonia.
Schleder BJ. Other articles in the series can be found online at http: Mechanical interventions include tooth brushing and rinsing of the oral cavity to remove dental plaque; pharmacological interventions involve the use of antimicrobial agents. Exact speciation of pathogen bacteria and their sensitivity to antibiotics can take a few days, but provides invaluable information.
Thorax 1999, 54: Suctioning techniques for the removal of respiratory secretions [published correction appears in Nurs Stand. Mucus in the airways can become stagnant and serve as a medium for bacterial growth. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: Usual duration of therapy is 8 days unless treatment is for multidrug resistant organisms, in which case treatment will be for 14 days.
It was updated in 2010 to include oral hygiene with adequate strength anti-septics, subglottic aspiration, and TT cuff pressure monitoring in addition to the initial four care interventions. VAP is associated with increases in morbidity and mortality, hospital length of stay, and costs.
The sensitivity and specificity of presence of infiltrates on chest X-ray is also not encouraging [ 12 ]. The goals were to capture other common complications of ventilator care, to improve objectivity of surveillance to allow comparability across centers for public reporting, and to minimize gaming [ 30 ].