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L Holzapfel C Chastang G Demingeon, et al. 1999 A randomized study assessing the systematic search for maxillary sinusitis in nasotracheally mechanically ventilated patients. Influence of nosocomial maxillary sinusitis on the occurrence of ventilator-associated pneumonia Am J Respir Crit Care Med. 159 695 701 10051239 1:STN:280:DyaK1M7mtVOksA%3D%3D (Pubitemid 29137762)
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18714060 10.1001/jama.300.7.805 1:CAS:528:DC%2BD1cXhtVWkurjO This article describes the first RCT examining the role of silver-coated endotracheal tubes and their role in the prevention of VAP
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M Kollef B Afessa A Anzueto, et al. 2008 Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial JAMA. 300 805 813 18714060 10.1001/jama.300.7.805 1:CAS:528:DC%2BD1cXhtVWkurjO This article describes the first RCT examining the role of silver-coated endotracheal tubes and their role in the prevention of VAP
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19538095 10.1086/599005 An analysis of the cost effectiveness of the use of silver-coated endotracheal tubes in the prevention of VAP with the aid of a theoretical model
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AF Shorr MD Zilberberg M Kollef 2009 Coast-effectiveness analysis of silver-coated endotracheal tubes to reduce the incidence of ventilator- associated pneumonia Infect Control Hosp Epidemiol. 30 759 763 19538095 10.1086/599005 An analysis of the cost effectiveness of the use of silver-coated endotracheal tubes in the prevention of VAP with the aid of a theoretical model
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10.1093/bja/aeq202 1:STN:280:DC%2BC3cfhvFymsQ%3D%3D This recent paper demonstrates that in an in vitro study, polyurethane cuffs showed less leakage than PVC cuffs. The investigators also demonstrated that tapered cuffs were not inferior to cylindrical cuffs, and may in fact be superior to cylindrical cuffs in decreasing fluid leakage past the cuffs
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MH Dave A Frotzler N Spielmann C Madjdpour M Weiss 2010 Effect of tracheal tube cuff shape on fluid leakage across the cuff: an in vitro study Brit J Anaes. 105 538 543 10.1093/bja/aeq202 1:STN:280:DC%2BC3cfhvFymsQ%3D%3D This recent paper demonstrates that in an in vitro study, polyurethane cuffs showed less leakage than PVC cuffs. The investigators also demonstrated that tapered cuffs were not inferior to cylindrical cuffs, and may in fact be superior to cylindrical cuffs in decreasing fluid leakage past the cuffs
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Subglottic secretion drainage for preventing ventilator-associated pneumonia: A meta-analysis
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C Dezfulian K Shonjania H Collard, et al. 2005 Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis Am J Med. 118 11 18 15639202 10.1016/j.amjmed.2004.07.051 (Pubitemid 40082451)
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JC Lacherade B De Jonghe P Guenzennec 2010 Intermittent subglottic secretion drainage and ventilator-associated pneumonia: a multicenter trial Am J Respir Crit Care Med. 182 910 917 20522796 10.1164/rccm.200906-0838OC
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E Bouza MJ Perez P Munoz, et al. 2008 Continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in post-operative period of major heart surgery Chest. 134 938 946 18641114 10.1378/chest.08-0103
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19050607 10.1097/CCM.0b013e3181930026 This article examines the effect of saline instillation before suction on VAP. The investigators determined that with saline instillation, incidence of VAP was decreased
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P Caruso S Denari SAL Ruiz SE Demarzo D Deheinzelin 2009 Saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia Crit Care Med. 37 32 38 19050607 10.1097/CCM.0b013e3181930026 This article examines the effect of saline instillation before suction on VAP. The investigators determined that with saline instillation, incidence of VAP was decreased
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18664777 10.1097/CCM.0b013e31817b8a92 This paper examined the effects of PEEP versus no PEEP on VAP, and determined that minimal amounts of PEEP-regardless of the oxygenation of intubated patients-decreased the incidence of VAP
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F Manzano E Fernandez-Mondejar M Colmenero, et al. 2008 Positive-end expiratory pressure reduces incidence of ventilator-associated pneumonia in non hypoxemic patients Crit Care Med. 36 2225 2231 18664777 10.1097/CCM. 0b013e31817b8a92 This paper examined the effects of PEEP versus no PEEP on VAP, and determined that minimal amounts of PEEP-regardless of the oxygenation of intubated patients-decreased the incidence of VAP
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20407057 10.1001/jama.2010.447 1:CAS:528:DC%2BC3cXltlCgsbY%3D This article describes a 600-patient, multicenter, Italian, RCT that examined the role of early tracheostomy for the prevention of VAP. Investigators determined that early tracheostomy versus late tracheostomy did not prevent the development of VAP
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P Terragni M Antonelli R Fumagalli, et al. 2010 Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients a randomized controlled trial JAMA. 303 1483 1489 20407057 10.1001/jama.2010.447 1:CAS:528:DC%2BC3cXltlCgsbY%3D This article describes a 600-patient, multicenter, Italian, RCT that examined the role of early tracheostomy for the prevention of VAP. Investigators determined that early tracheostomy versus late tracheostomy did not prevent the development of VAP
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R Tiruvoipati M Bangash B Manktelow GJ Peek 2008 Efficacy of prone ventilation in adult patients with acute respiratory failure: a meta-analysis J Crit Care. 23 101 110 18359427 10.1016/j.jcrc.2007.09.003 A meta-analysis of five studies examining the effect of prone ventilation in patients. The authors did not find any reduction in mortality, pneumonia, or length of ICU stay with prone ventilation, but did find improved oxygenation (Pubitemid 351400348)
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Continuous lateral rotation therapy to prevent ventilator-associated pneumonia
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19789440 10.1097/CCM.0b013e3181bc8218 The authors of this prospective randomized trial examined the effect of continuous lateral rotation to prevent VAP. They found that it did reduce VAP, but was also technically difficult and at times not tolerated by patients
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T Staudinger A Bojic U Holzinger, et al. 2010 Continuous lateral rotation therapy to prevent ventilator-associated pneumonia Crit Care Med. 38 486 490 19789440 10.1097/CCM.0b013e3181bc8218 The authors of this prospective randomized trial examined the effect of continuous lateral rotation to prevent VAP. They found that it did reduce VAP, but was also technically difficult and at times not tolerated by patients
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19118302 10.1056/NEJMoa0800394 The authors of this clinical trial examined the role of decontamination of the digestive tract and oropharynx in ICU patients. They found a 3.5% reduction in mortality in patients with selective decontamination of the digestive tract, and a 2.9% reduction in mortality in patients with selective oral decontamination at 28 days
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AM de Smet JA Kluytmans BS Cooper, et al. 2009 Decontamination of the digestive tract and oropharynx in ICU patients N Engl J Med. 360 20 31 19118302 10.1056/NEJMoa0800394 The authors of this clinical trial examined the role of decontamination of the digestive tract and oropharynx in ICU patients. They found a 3.5% reduction in mortality in patients with selective decontamination of the digestive tract, and a 2.9% reduction in mortality in patients with selective oral decontamination at 28 days
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EY Chan A Ruest M O'Meade, et al. 2007 Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis BMJ. 10.1136/bmj.39136.528160.BE (Pubitemid 46724331)
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Randomized controlled trial and meta-analysis of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia
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H Tantipong C Morkchareonpong S Jaiyindee V Thamlikitkul 2008 Randomized controlled trial and meta-analysis of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia Inf Cont Hosp Epidemiol. 29 131 136 10.1086/526438 The authors of this study determined that oral decontamination with 2% chlorhexidine is associated with a decreased incidence of VAP (Pubitemid 351269208)
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ME Falagas II Siempos IA Bliziotis A Michalopoulos 2006 Administration of antibiotics via the respiratory tract for the prevention of ICU-acquired pneumonia: a meta-analysis of comparative trials Critical Care. 10 R123 10.1186/cc5032 16934148 10.1186/cc5032 (Pubitemid 47086878)
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Aerosolized ceftazidime prophylaxis against ventilator-associated pneumonia in high-risk trauma patients: Results of a double-blind randomized study
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JA Claridge NM Edwards J Swanson, et al. 2007 Aerosolized ceftazidime prophylaxis against ventilator-associated pneumonia in high-risk trauma patients: results of a double-blind randomized study Surg Inf. 7 83 90 10.1089/sur.2006.042 (Pubitemid 46598298)
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Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: A meta-analysis of randomized controlled trials
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20016381 10.1097/CCM.0b013e3181c8fe4b This recent meta-analysis depicts how probiotics may be associated with decreased incidence of VAP
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II Siempos TK Ntaidou ME Falagas 2010 Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials Crit Care Med. 38 954 962 20016381 10.1097/CCM.0b013e3181c8fe4b This recent meta-analysis depicts how probiotics may be associated with decreased incidence of VAP
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Institute for Healthcare Improvement Ventilator Bundle Accessed November 2010
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Institute for Healthcare Improvement Ventilator Bundle available at: http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/Changes/ ImplementtheVentilatorBundle.htm. Accessed November 2010.
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77049125763
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Accuracy of clinical definitions of ventilator-associated pneumonia: Comparison of autopsy findings
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19592209 10.1016/j.jcrc.2009.05.008 This recent paper compared the accuracy of clinical and microbiological diagnostic criteria with the autopsy diagnosis of VAP. Clinical criteria were found to have poor sensitivities and specificities for the diagnosis of VAP, but did improve with microbiological confirmation
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E Tejerina A Esteban P Fernandez-Segoviano, et al. 2010 Accuracy of clinical definitions of ventilator-associated pneumonia: comparison of autopsy findings J Crit Care. 25 62 68 19592209 10.1016/j.jcrc.2009.05.008 This recent paper compared the accuracy of clinical and microbiological diagnostic criteria with the autopsy diagnosis of VAP. Clinical criteria were found to have poor sensitivities and specificities for the diagnosis of VAP, but did improve with microbiological confirmation
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DK Heyland D Cook P Dodek J Muscedere A Day 2006 A randomized trial of diagnostic techniques for ventilator-associated pneumonia N Engl J Med. 355 2619 30 10.1056/NEJMoa052904 1:CAS:528:DC%2BD28XhtlGhtLvI (Pubitemid 44969121)
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Patrick, W.73
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McCallum, C.78
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more..
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34
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33846409078
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Direct E-test (AB Biodisk) of respiratory samples improves antimicrobial use in ventilator-associated pneumonia
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This study examined the effect of E-test for the treatment of VAP. E-test was shown to improve antibiotic use in the treatment of VAP 82-387
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E Bouza M Torres C Radice, et al. 2007 Direct E-test (AB Biodisk) of respiratory samples improves antimicrobial use in ventilator-associated pneumonia Clin Inf Dis. 44 3 82 387 This study examined the effect of E-test for the treatment of VAP. E-test was shown to improve antibiotic use in the treatment of VAP
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Sequential measurements of procalcitonin levels in diagnosing ventilator-associated pneumonia
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17959634 10.1183/09031936.00086707 1:CAS:528:DC%2BD1cXit12hu7c%3D This is an important article about examining CRP and PCT levels in making the diagnosis of VAP. The authors arrive at a clinical decision-making tool involving PCT for the diagnosis of VAP
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P Ramirez MA Garcia M Ferrer, et al. 2008 Sequential measurements of procalcitonin levels in diagnosing ventilator-associated pneumonia Eur Respir J. 31 356 362 17959634 10.1183/09031936.00086707 1:CAS:528:DC%2BD1cXit12hu7c%3D This is an important article about examining CRP and PCT levels in making the diagnosis of VAP. The authors arrive at a clinical decision-making tool involving PCT for the diagnosis of VAP
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18849395 10.1378/chest.08-1829 This prospective cohort study found that sTREM-1 may have minimal diagnostic value for VAP
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NJ Anand S Zuick J Klesney-Tait MH Kollef 2009 Diagnostic implications of soluble triggering receptor expressed on myeloid-1 cells in BAL fluid in patients with pulmonary infiltrates in the ICU Chest. 135 641 647 18849395 10.1378/chest.08-1829 This prospective cohort study found that sTREM-1 may have minimal diagnostic value for VAP
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Chest
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Anand, N.J.1
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G Horonenko JC Hoyt RA Robbins, et al. 2007 Soluble triggering receptor expressed on myeloid-1 cells is increased with patients with ventilator associated pneumonia: A preliminary report Chest. 132 58 63 17505044 10.1378/chest.06-2731 1:CAS:528:DC%2BD2sXovFKltbc%3D This article describes a prospective study that found that sTREM-1 may be useful in diagnosing VAP (Pubitemid 47068203)
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Chest
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Horonenko, G.1
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19343323 10.1007/s00134-009-1463-y 1:CAS:528:DC%2BD1MXnsVWmsb4%3D This observational study found that sTREM-1 in BAL is not useful in the diagnosis of VAP
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GJ Oudhuis J Beuving D Bergmans, et al. 2009 Soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid is not predictive for ventilator-associated pneumonia Intensive Care Med. 35 1265 1270 19343323 10.1007/s00134-009-1463-y 1:CAS:528:DC%2BD1MXnsVWmsb4%3D This observational study found that sTREM-1 in BAL is not useful in the diagnosis of VAP
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EL Kuti AA Patel CI Coleman 2008 Impact of inappropriate antibiotic therapy on mortality in patients with ventilator-associated pneumonia and blood stream infections: a meta-analysis J Crit Care 23 91 100 18359426 10.1016/j.jcrc.2007.08.007 Inappropriate initial antibiotic therapy is associated with increased mortality in VAP. (Pubitemid 351400347)
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Journal of Critical Care
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Kuti, E.L.1
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DOI 10.1016/j.jcrc.2007.12.006, PII S0883944108000063
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AR Joffe J Muscedere JC Marschall Y Su DK Heyland 2008 The safety of targeted antibiotic therapy for ventilator-associated pneumonia: a multicenter observational study J Crit Care. 23 82 90 18359425 10.1016/j.jcrc.2007.12.006 This observational study found that targeted antibiotic therapy for VAP was associated with less antibiotic use and was not associated with any increased harm (Pubitemid 351400353)
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Journal of Critical Care
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Joffe, A.R.1
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Randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia
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18091545 10.1097/01.CCM.0B013E31816203D6 Monotherapy is not inferior to combination therapy for the treatment of VAP. There is a trend for patients with late-onset VAP to do better with combination therapy versus monotherapy
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DK Heyland P Dodek J Muscedere 2008 Randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia Crit Care Med. 36 737 744 18091545 10.1097/01.CCM.0B013E31816203D6 Monotherapy is not inferior to combination therapy for the treatment of VAP. There is a trend for patients with late-onset VAP to do better with combination therapy versus monotherapy
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18812452 10.1378/chest.08-1617 The authors report that VAT may be an important risk factor for the development of VAP, and treatment of VAT may result in a lower incidence of VAP.
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DE Craven A Chroneou N Zias KI Hjalmarson 2009 Ventilator-associated tracheobronchitis: the impact of targeted antibiotic therapy on patient outcomes CHEST. 135 521 528 18812452 10.1378/chest.08-1617 The authors report that VAT may be an important risk factor for the development of VAP, and treatment of VAT may result in a lower incidence of VAP.
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• Nseir S, Favory R, Josefowicz J, et al.: Antimicrobial treatment for ventilator-associated tracheobronchitis: a randomized, controlled, multicenter study, Critical Care 2008, 12:R62 doi: 10.1186/cc6890. Available online at http://ccforum.com/content/12/3/R62. Accessed October 2010. In patients with VAT, antimicrobial treatment is associated with lower rates of VAP and ICU mortality. (Pubitemid 351753656)
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Critical Care
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Nseir, S.1
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18552684 10.1097/CCM.0b013e31817c0f9e 1:CAS:528:DC%2BD1cXotVyls7k%3D This article describes a double-blind RCT examining the role of aerosolized antibiotics and VAT in the ICU. The authors found that with aerosolized antibiotics, there was a significant reduction in VAP, which facilitated weaning and decreased administration of systemic antibiotics
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LB Palmer GC Smaldone JJ Chen, et al. 2008 Aerosolized antibiotics and ventilator-associated tracheobronchitis in the intensive care unit Crit Care Med. 36 2008 2013 18552684 10.1097/CCM.0b013e31817c0f9e 1:CAS:528: DC%2BD1cXotVyls7k%3D This article describes a double-blind RCT examining the role of aerosolized antibiotics and VAT in the ICU. The authors found that with aerosolized antibiotics, there was a significant reduction in VAP, which facilitated weaning and decreased administration of systemic antibiotics
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AM Nicasio KJ Eagye DP Nicolau, et al. 2010 Pharmacodynamic-based clinical pathway for empiric antibiotic choice in patients with ventilator-associated pneumonia J Crit Care. 25 69 77 19427167 10.1016/j.jcrc.2009.02.014 1:CAS:528:DC%2BC3cXksVyksbc%3D
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Chastre, J.1
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19797133 10.1183/09031936.00053209 1:CAS:528:DC%2BC3cXltVWrtw%3D%3D This article describes a multicenter RCT that found following PCT levels reduces patient exposure to antibiotics in the treatment of VAP.
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D Stolz N Smyrnios P Eggimann, et al. 2009 Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia: a randomised study Eur Respir J. 34 1364 1375 19797133 10.1183/09031936.00053209 1:CAS:528: DC%2BC3cXltVWrtw%3D%3D This article describes a multicenter RCT that found following PCT levels reduces patient exposure to antibiotics in the treatment of VAP.
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10.1016/S0140-6736(09)61879-1 This article describes a large, multicenter, randomized trial examining the role of PCT in guiding continued antimicrobial therapy for VAP. The authors found that by using PCT with specific cut-off criteria, the duration of antimicrobial therapy could be shortened with no adverse effects.
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L Bouadama CE Luyt F Tubach, et al. 2010 Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomized controlled trial Lancet. 375 463 74 10.1016/S0140- 6736(09)61879-1 This article describes a large, multicenter, randomized trial examining the role of PCT in guiding continued antimicrobial therapy for VAP. The authors found that by using PCT with specific cut-off criteria, the duration of antimicrobial therapy could be shortened with no adverse effects.
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