Ventilator-associated events prevention, learning lessons from the past: A systematic review

被引:27
作者
Chahoud, Jad [1 ]
Semaan, Adele [2 ]
Almoosa, Khalid F. [1 ,3 ]
机构
[1] Univ Texas Hlth Sci Ctr Houston, Sch Med, Dept Internal Med, Houston, TX 77030 USA
[2] Univ Texas Hlth Sci Ctr Houston, Sch Publ Hlth, Dept Management Policy & Community Hlth, Houston, TX 77030 USA
[3] Mem Hermann Hosp TMC, Transplant Surg ICU, Houston, TX USA
来源
HEART & LUNG | 2015年 / 44卷 / 03期
基金
美国国家卫生研究院;
关键词
Ventilator-associated pneumonia; Ventilator-associated Events; Prevention; Bundles; Surveillance; Critical care; HOSPITAL-ACQUIRED PNEUMONIA; INTENSIVE-CARE UNITS; MULTIDIMENSIONAL APPROACH; ATTRIBUTABLE MORTALITY; CRITICALLY-ILL; INFECTION; IMPACT; BUNDLE; EPIDEMIOLOGY; SURVEILLANCE;
D O I
10.1016/j.hrtlng.2015.01.010
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Background: Preventing Ventilator-associated events (VAE) is a major challenge. Strictly monitoring for ventilator-associated pneumonia (VAP) is not sufficient to ensure positive outcomes. Therefore, the surveillance definition was updated and a change to the broader VAE was advocated. Objective: This paper summarizes the scientific efforts assessing VAP preventive bundles and the recent transition in surveillance methods. Methods: We conducted a systematic review to identify lessons from past clinical studies assessing VAP prevention bundles. We then performed a thorough literature review on the recent VAE surveillance algorithm, highlighting its advantages and limitations. Conclusion: VAP prevention bundles have historically proven their efficacy and the introduction of the new VAE definition aimed at refining and objectivizing surveillance methods. Randomized controlled trials remain vital to determine the effect of VAE prevention on patient outcomes. We recommend expanding beyond limited VAP prevention strategies towards VAE prevention bundles. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:251 / 259
页数:9
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