Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study.

Bert Maertens, Stijn Blot, Diana Huis In 't Veld, Koen Blot, Annelies Koch, Katrien Mignolet, Elise Pannier, Tom Sarens, Werner Temmerman, Walter Swinnen
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Abstract

Objective: To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.

Design: Historical observational surveillance study conducted over 13 years.

Setting: A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.

Participants: Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.

Interventions: Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, chlorhexidine oral care, and daily sedation assessment.

Measurements and main results: A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.

Conclusions: Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.

Implications for practice: The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.

逐步实施预防策略及其对呼吸机相关肺炎发病率的影响:一项为期 13 年的观察性监测研究。
目的描述通过逐步引入预防策略来预防和控制呼吸机相关肺炎(VAP)的做法,并评估对 VAP 发生率的影响:设计:历时 13 年的历史性观察监测研究:地点:比利时一家综合医院拥有 12 张病床的成人重症监护病房(ICU):干预措施:干预措施:从2008年起逐步引入VAP预防措施,包括抬高床头、控制袖带压力、使用锥形袖带的气管插管、声门下分泌物引流、洗必泰口腔护理和每日镇静评估:从基线到最后阶段,VAP发病密度明显下降,从每1000个呼吸机日18.3例降至2.6例:结论:系统性地实施 VAP 预防措施大大降低了 VAP 的发生率。结论:系统性地实施 VAP 预防措施大大降低了 VAP 的发生率,但这种降低并没有转化为 ICU 整体死亡率的下降:这项研究强调了持续的 VAP 监测和预防措施对降低 VAP 发生率的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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