Ventilator-associated pneumonia (VAP) is a potentially preventable iatrogenic illness that may develop following mechanical ventilation. A bundle for the prevention of VAP consists of different measures which may vary between institutions, and may include: elevation of the head of the bed, oral care with chlorhexidine, subglottic suctioning, daily assessment for extubation and the need for proton-pump inhibitors, use of closed suction systems, and maintaining endotracheal cuff pressure at 25 cmH2O. Our aim was to determine the efficacy of a VAP prevention bundle, consisting of the above-mentioned measures, by evaluating the incidence of VAP before (no-VAP-B group) and after (VAP-B group) the introduction of the bundle. We retrospectively evaluated the data for patients who were mechanically ventilated with an endotracheal tube, in the period between 1 September and 31 December 2014 (no-VAP-B group, n = 55, 54.5% males, mean age 67.8 ± 14.5 years) and between 1 January to 30 April 2015 (VAP-B group, n = 74, 62.1% males, mean age 64.8 ± 13.7 years). There were no statistically significant differences between no-VAP-B and VAP-B groups in demographic data, intensive care unit (ICU) mortality, hospital mortality, duration of ICU treatment, and duration of mechanical ventilation. No significant differences in the rates of VAP and early VAP (onset ≤7 days after intubation) were found between no-VAP-B and VAP-B groups (41.8% versus 25.7%, p = 0.06 and 10.9% versus 12.2%, p > 0.99, respectively). However, a significant decrease in the late VAP (onset >8 days after intubation) was found in VAP-B group compared to no-VAP-B group (13.5% versus 30.9%, p = 0.027). Overall, our results support the use of VAP prevention bundle in clinical practice.

中文翻译：

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集束治疗方法在预防呼吸机相关性肺炎（VAP）发生方面的功效。


呼吸机相关性肺炎 (VAP) 是一种潜在可预防的医源性疾病，可能在机械通气后发生。预防 VAP 的一系列措施由不同的措施组成，这些措施可能因机构而异，可能包括：抬高床头、用洗必泰进行口腔护理、声门下抽吸、拔管的日常评估以及质子泵抑制剂的需要，使用封闭式吸引系统，并将气管套囊压力维持在 25 cmH2O。我们的目的是通过评估引入捆绑之前（无 VAP-B 组）和引入之后（VAP-B 组）VAP 的发生率，确定由上述措施组成的 VAP 预防捆绑的有效性。我们回顾性评估了 2014 年 9 月 1 日至 12 月 31 日期间使用气管插管进行机械通气的患者的数据（无 VAP-B 组，n = 55，54.5% 男性，平均年龄 67.8 ± 14.5 岁）和2015年1月1日至4月30日期间（VAP-B组，n = 74，62.1%为男性，平均年龄64.8±13.7岁）。 no-VAP-B 组和 VAP-B 组在人口统计学数据、重症监护病房 (ICU) 死亡率、住院死亡率、ICU 治疗持续时间和机械通气持续时间方面没有统计学显着差异。无 VAP-B 组和 VAP-B 组之间 VAP 和早期 VAP（插管后 7 天以内发病）的发生率没有显着差异（41.8% vs 25.7%，p = 0.06 和 10.9% vs 12.2%，p > 0.99，分别）。然而，与无 VAP-B 组相比，VAP-B 组的晚期 VAP（插管后 8 天以上发病）显着下降（13.5% vs 30.9%，p = 0.027）。总体而言，我们的结果支持 VAP 预防组合在临床实践中的使用。