Table 2 Non-antibiotic preventive strategies for nosocomial pneumonia in mechanically ventilated patients according to their effectiveness based on criteria of the Centers for Disease Control (CDC) [30]and of the European Task Force on ventilator-associated pneumonia (Task Force) [65]
From: Clinical review: Non-antibiotic strategies for preventing ventilator-associated pneumonia
| Â | CDC | Task Force |
|---|---|---|
Do not routinely change the breathing circuit more frequently than every week | Recommended | Not controversial |
Humidification system: heat and moisture exchangers versus heated humidification | Unresolved | Still controversial |
Avoid in-line nebulisers | Not mentioned | Still controversial |
Handwashing | Recommended | Not controversial |
Chlorhexidine oral rinse | Not mentioned | Not mentioned |
Multiple-use, closed-system suction catheter or the single-use, open-system catheter | Unresolved | Still controversial, should be investigated |
Semirecumbent body position | Recommended | Not controversial |
Nasojejunal enteral nutrition | Unresolved | Should be investigated |
Small-bore tubes for enteral feeding | Unresolved | Should be investigated |
Orotracheal instead of nasotracheal intubation | Unresolved | Not controversial |
Continuous suction of subglottic secretions | Unresolved | Still controversial, should be investigated |
Cuff pressure optimisation | Not mentioned | Not controversial |
Stress ulcer prophylaxis | Unresolved | Still controversial, should be investigated |
Avoid gastric overdistension | Recommended | Not mentioned |
Kinetic beds | Unresolved | Not mentioned |
Avoid deep sedation paralytic medication | Not mentioned | Not controversial |
Non-invasive mechanical ventilation | Not mentioned | Not controversial, should be investigated |