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Posted: September 1st, 2022
Preventing and Managing Ventilator-Associated Pneumonia
Preventing and Managing Ventilator-Associated Pneumonia
Ventilator-associated pneumonia (VAP) is a form of lung infection common in patients receiving invasive mechanical ventilation (IMV). VAP may occur if the air or the endotracheal and tracheostomy tubes transfer microorganisms to the lungs, causing the infection. VAP is a major complication that results from IMV and contributes to increased mortality rates in the ICU. It worsens the medical conditions of already critically ill patients, increasing their duration of stay and the cost of hospitalization.
In the past years, increased mortality rates resulting from VAP has prompted the introduction of measures that seek to prevent and manage incidents of ventilator-associated pneumonia. These following measures have been very effective in controlling and reducing incidents of VAP.
• Noninvasive mechanical ventilation. The use of noninvasive mechanical ventilation (NIMV) is believed to lower incidences of VAP. Therefore, when applicable, NIMV methods should be considered before settling on using IMV.
• Minimizing ventilator exposure. When noninvasive ventilation is not an option, health care providers should consider decreasing the duration in which the patient is exposed to mechanical ventilation. Reducing the length of exposure is known to lower the likelihood of developing VAP.
• Intensive oral hygiene. Due to the incapacitated condition, the oral hygiene of the mechanically ventilated patients deteriorates very fast. This creates a conducive environment for germs and microorganisms to thrive, which, in addition to the weakened immune system of the patient, increases the risk of developing VAP. Intensive and professional oral care for the patients will reduce in ICU will reduce bacterial growth, which in turn, lowers the risk of infection.
• Subglottic suctioning. The oropharyngeal secretions that accumulate in and around the tubes also pose a very high risk of infection. Subglottic secretion suctioning is used to drain the secretions, preventing and reducing the risk of infection. According to research, subglottic suctioning lowers the risk of developing VAP by 45%.
• Proper positioning and increased mobility. Placing the bed at an elevated position of between 30-45 degrees and encouraging early mobility has been shown to prevent and decrease the probability of developing VAP.
• The use of probiotics. Administering probiotics to mechanically ventilated patients has been shown to decrease the risk of developing VAP. Probiotic bacteria work by increasing host cell antimicrobial peptides and reducing the overgrowth of bacteria and other microorganisms that causes VAP.
VAP is and will probably remain the major infection and cause of many death in the ICU. The above strategies have been effectively used to prevent and treat the incidences of ventilator-associated pneumonia.
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