Skip to main content

Table 4 Suggested measures for prevention of ventilator-associated pneumonia (VAP) [41], [42], [49]

From: Ventilator-associated pneumonia in the ICU

ICU focused measures Institution focused measures
Alcohol-based hand washing policy Surveillance program for pathogen profiling and creation of “antibiogram”
Early discontinuation of invasive devices Frequent educational programs to reduce unnecessary antibiotic prescription
Reduce reintubation rates Propagate use of non-invasive positive pressure ventilation (NIPPV)
Use of oropharyngeal vs. nasopharyngeal feeding tubes Endotracheal tubes (ETTs) with potential benefit:
  Polyurethane-cuffed ETT
  Silver/antibiotic coated ETT
  Aspiration of subglottic secretions (HI-LO ETT)
Semi-recumbent patient positioning (30-45°) Maintain policy for oral decontamination
  Selective digestive decontamination (SDD)
Endotracheal tube cuff pressure ~ 20 cm H2O Early weaning and extubation
Early tracheostomy Daily sedation holds
Small bowel feeding instead of gastric feeding Preference on using heat-moisture exchangers over heater humidifiers
Prophylactic probiotics Mechanical removal of the biofilm (e. g., the mucus shaver)