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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.
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