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Table 1 Randomized controlled trials of interventions to prevent ventilator-associated pneumonia

From: The paradox of ventilator-associated pneumonia prevention measures

  Impact on
  Subjects VAP rates Ventilator LOS ICU LOS Hospital LOS Mortality
Elevation of the head of the bed       
   Drakulovic, et al., 1999 [5] 86 78% ↓ NS NS - NS
   van Nieuwenhoven, et al., 2006 [46] 221 NS NS NS - NS
Oral care       
   Chlorhexidine       
DeRiso, et al., 1996 [40] 353 NS NS - NS 80% ↓
Fourrier, et al., 2000 [1] 60 66% ↓ NS NS - NS
Genuit, et al., 2001 [2] 95 37% ↓ NS NS NS -
Houston, et al., 2002 [47] 561 NS NS - - -
Fourrier, et al., 2005 [48] 228 NS NS NS - NS
Koeman, et al., 2006 [3] 257 NS NS NS NS NS
Segers, et al., 2006 [49] 954 50% ↓ - NS 8% ↓ NS
Tantipong, et al., 2008 [50] 207 NS - - - NS
Chan, et al., 2007 [4] (meta-analysis) 2,144 44% ↓ NS NS - NS
   Oral topical antibiotics       
Laggner, et al., 1994 [51] (gentamicin) 67 NS NS - - NS
Bergmans, et al., 2001 [52] (gentamicin, colistin, vancomycin) 226 57%-68% ↓ NS NS NS NS
Kollef, et al., 2006 [53] (iseganan) 709 NS - - - NS
Chan, et al., 2007 [4] (meta-analysis) 1,098 NS NS NS - NS
de Smet, et al., 2009 [31] (tobramycin, colistin, amphotericin B) 3,894 - NS NS NS 14% ↓
Deep vein thrombosis prophylaxis       
   Samama, et al., 1999 [54] 1,102 - - - - NS
   Fraisse, et al., 2000 [55] 223 - - - - NS
   Leizorovicz, et al., 2004 [56] 3,706 - - - - NS
   Mahé, et al., 2005 [57] 2,474 - - - - NS
Stress ulcer prophylaxis       
   Prod'hom, et al., 1994 [58] 248 NS - - - NS
   Bonten, et al., 1995 [59] 141 NS - - NS NS
   Yildizdas, et al., 2002 [60] 160 NS - - - NS
   Kantorova, et al., 2004 [61] 287 NS NS NS - NS
   Cook, et al., 1996 [10] (meta-analysis) 7,218 NS - - - NS
Continuous aspiration of subglottic secretions       
   Valles, et al., 1995 [6] 153 37% ↓ - NS - NS
   Kollef, et al., 1999 [62] 343 39% ↓ NS NS NS NS
   Smulders, et al., 2002 [63] 150 75% ↓ NS NS NS NS
   Lorente, et al., 2007 [64] 280 64% ↓ NS NS - NS
   Bouza, et al., 2008 [39] 690 NS NS NS NS NS
Silver-coated endotracheal tubes       
   Kollef, et al., 2008 [8] 2,003 36% ↓ NS NS NS NS
  1. ICU, intensive care unit; LOS, length of stay; NS, not statistically significant; VAP, ventilator-associated pneumonia; Ventilator LOS, duration of mechanical ventilation.