Skip to main content
  • Poster presentation
  • Open access
  • Published:

Strategies for reducing the time of mechanical ventilation and ventilator-associated pneumonia

Introduction

Ventilator-associated pneumonia (VAP) is one of the most frequent causes of nosocomial infection and complication in the intensive care unit (ICU). VAP is associated with increased mortality and morbidity, as well as increased costs of intensive therapy.

Objective

To compare the prevalence of VAP and the duration of mechanical ventilation in a general ICU, before and after implantation of a bundle of four and five measures.

Methods

A prospective study made in the general ICU, from December 2007 to November 2009, with a total of 432 patients. The measures adopted in the bundle of VAP were: daily sedative interruption, elevation of the head of the bed to 45°, deep venous thrombosis prophylaxis, peptic ulcer disease prophylaxis. The fifth measure used was the daily interruption of sedatives with spontaneous breathing trials (SBTs). The control group was the group without the VAP bundle. Group 1 was with the VAP bundle. Group 2 was the group of VAP bundle with daily interruption of sedatives and SBTs.

Results

Control group: 153 patients were ventilated from December 2006 to November 2007, with a mean ventilation time of 10.8 ± 2.2 days, as 41 patients were with VAP, 27.3% of VAP with 53.3% mortality. Group 1: 149 patients were ventilated from December 2007 to November 2008, with a mean ventilation time of 8.3 ± 2.3 days, as 13 patients were with VAP, 8.7% of VAP with 42% mortality. Group 2: 130 patients were ventilated from December 2008 to November 2009, with a mean ventilation time of 7 ± 2 days, as two patients were with VAP, 1.5% of VAP with 41.5% mortality. All VAP cases on 15 patients happened after the fourth day of MV; that is, all of them were cases of late VAP. See Tables 1 and 2 and Figure 1.

Table 1
Table 2
figure 1

Figure 1

Conclusion

Implementation of a daily bundle with SBTs is associated with reduction of mechanical ventilation time, and it is the determinant factor to have lower indexes of VAP.

Author information

Authors and Affiliations

Authors

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Guimaraes, B., Nemer, S., Azeredo, L. et al. Strategies for reducing the time of mechanical ventilation and ventilator-associated pneumonia. Crit Care 15 (Suppl 2), P44 (2011). https://doi.org/10.1186/cc10192

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/cc10192

Keywords