Ventilator-associated pneumonia: The potential critical role of emergency medicine in prevention

Journal of Emergency Medicine

Volumn 42, Issue 3, 2012, Pages 353-362

  Grap, Mary Jo ^a   Munro, Cindy L ^a   Unoki, Takeshi ^b   Hamilton, V Anne ^a   Ward, Kevin R ^a  

^a VIRGINIA COMMONWEALTH UNIVERSITY   (United States)

^b ST LUKE'S INTERNATIONAL UNIVERSITY   (Japan)

Author keywords

backrest elevation; chlorhexidine; oral care; prevention; ventilator associated pneumonia

Indexed keywords

CHLORHEXIDINE;

ALKALINIZATION; ARTICLE; ARTIFICIAL VENTILATION; BRONCHUS SECRETION; EMERGENCY MEDICINE; ENDOTRACHEAL CUFF; ENDOTRACHEAL INTUBATION; ENDOTRACHEAL TUBE; HAEMOPHILUS INFLUENZAE; HUMAN; INTENSIVE CARE UNIT; LENGTH OF STAY; LUNG ASPIRATION; LUNG INFECTION; MORBIDITY; MORTALITY; MOUTH CAVITY; MOUTH HYGIENE; NONHUMAN; PATHOPHYSIOLOGY; PATIENT MONITORING; PATIENT POSITIONING; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RISK FACTOR; STAPHYLOCOCCUS AUREUS; STREPTOCOCCUS; SYSTEMATIC REVIEW (TOPIC); TOOTH BRUSHING; TOOTH PLAQUE; TRACHEOBRONCHIAL TOILET; VENTILATOR ASSOCIATED PNEUMONIA;

EVIDENCE-BASED EMERGENCY MEDICINE; HUMANS; INTUBATION, INTRATRACHEAL; PNEUMONIA, VENTILATOR-ASSOCIATED; POSTURE; RISK FACTORS; RISK MANAGEMENT;

EID: 84858702872     PISSN: 07364679     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jemermed.2010.05.042     Document Type: Article

References (103)

1. E.P. Rivers, V. Coba, and M. Whitmill Early goal-directed therapy in severe sepsis and septic shock: a contemporary review of the literature Curr Opin Anaesthesiol 21 2008 128 140
2. M.H. Kollef The prevention of ventilator-associated pneumonia N Engl J Med 340 1999 627 634
3. G.U. Meduri Diagnosis of ventilator-associated pneumonia Infect Dis Clin North Am 7 1993 295 329
4. V.M. Bradley Placing emergency department crowding on the decision agenda Nurs Econ 23 2005 14 24 3
5. M.J. Richards, J.R. Edwards, D.H. Culver, and R.P. Gaynes Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System Crit Care Med 27 1999 887 892
6. J.L. Vincent, D.J. Bihari, and P.M. Suter The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee JAMA 274 1995 639 644
7. N. Safdar, C. Dezfulian, H.R. Collard, and S. Saint Clinical and economic consequences of ventilator-associated pneumonia: a systematic review Crit Care Med 33 2005 2184 2193
8. J. Rello, D.A. Ollendorf, and G. Oster Epidemiology and outcomes of ventilator-associated pneumonia in a large US database Am J Respir Crit Care Med 122 2002 2115 2121
9. S. Nseir, F. Ader, and C.H. Marquette Nosocomial tracheobronchitis Curr Opin Infect Dis 22 2009 148 153
10. J. Chastre, and J.Y. Fagon Ventilator-associated pneumonia Am J Respir Crit Care Med 165 2002 867 903
11. M.H. Kollef, P. Silver, D.M. Murphy, and E. Trovillion The effect of late-onset ventilator-associated pneumonia in determining patient mortality Am J Respir Crit Care Med 108 1995 1655 1662
12. M.J. Eckert, K.A. Davis, and R.L. Reed Ventilator-associated pneumonia, like real estate: location really matters J Trauma 60 2006 104 110
13. National Nosocomial Infections Surveillance System National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004 Am J Infect Control 32 2004 470 485
14. E. Diaz, A.H. Rodriguez, and J. Rello Ventilator-associated pneumonia: issues related to the artificial airway Respir Care 50 2005 900 906
15. H. Kallel, H. Chelly, and M. Bahloul The effect of ventilator-associated pneumonia on the prognosis of head trauma patients J Trauma 59 2005 705 710
16. M. Cavalcanti, M. Ferrer, R. Ferrer, R. Morforte, A. Garnacho, and A. Torres Risk and prognostic factors of ventilator-associated pneumonia in trauma patients Crit Care Med 34 2006 1067 1072
17. M.J. Eckert, K.A. Davis, and R.L. Reed Urgent airways after trauma: who gets pneumonia? J Trauma 57 2004 750 755
18. B.G. Carr, A.J. Kaye, D.J. Wiebe, V.H. Gracias, C.W. Schwab, and P.M. Reilly Emergency department length of stay: a major risk factor for pneumonia in intubated blunt trauma patients J Trauma 63 2007 9 12
19. O.M. Garrouste, S. Chevret, and G. Arlet Oropharyngeal or gastric colonization and nosocomial pneumonia in adult intensive care unit patients. A prospective study based on genomic DNA analysis Am J Respir Crit Care Med 156 1997 1647 1655
20. M.J. Bonten, D.C. Bergmans, and A.W. Ambergen Risk factors for pneumonia, and colonization of respiratory tract and stomach in mechanically ventilated ICU patients Am J Respir Crit Care Med 154 1996 1339 1346
21. J.A. Cardenosa Cendrero, J. Sole-Violan, and B.A. Bordes Role of different routes of tracheal colonization in the development of pneumonia in patients receiving mechanical ventilation Am J Respir Crit Care Med 116 1999 462 470
22. S. Ewig, A. Torres, and M. el-Ebiary Bacterial colonization patterns in mechanically ventilated patients with traumatic and medical head injury. Incidence, risk factors, and association with ventilator-associated pneumonia Am J Respir Crit Care Med 159 1999 188 198
23. R. Garcia A review of the possible role of oral and dental colonization on the occurrence of health care-associated pneumonia: underappreciated risk and a call for interventions Am J Infect Control 33 2005 527 541
24. A.A. El-Solh, C. Pietrantoni, and A. Bhat Colonization of dental plaques: a reservoir of respiratory pathogens for hospital-acquired pneumonia in institutionalized elders Am J Respir Crit Care Med 126 2004 1575 1582
25. F. Fourrier, B. Duvivier, H. Boutigny, M. Rourrel-Delvallez, and C. Chopin Colonization of dental plaque: a source of nosocomial infections in intensive care unit patients Crit Care Med 26 1998 301 308
26. F. Fourrier, E. Cau-Pottier, H. Boutigny, M. Roussel-Delvallez, M. Jourdain, and C. Chopin Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients Intensive Care Med 26 2000 1239 1247
27. C.L. Munro, M.J. Grap, R.K. Elswick Jr., J. McKinney, C.N. Sessler, and R.S. Hummel III Oral health status and development of ventilator-associated pneumonia: a descriptive study Am J Crit Care 15 2006 453 460
28. F. Konrad, T. Schreiber, D. Brecht-Kraus, and M. Georgieff Mucociliary transport in ICU patients Chest 105 1994 237 241
29. S.A. Levine, and M.S. Niederman The impact of tracheal intubation on host defenses and risks for nosocomial pneumonia Clin Chest Med 12 1991 523 543
30. C.G. Adair, S.P. Gorman, and B.M. Feron Implications of endotracheal tube biofilm for ventilator-associated pneumonia Intensive Care Med 25 1999 1072 1076
31. T.J. Inglis, M.R. Millar, J.G. Jones, and D.A. Robinson Tracheal tube biofilm as a source of bacterial colonization of the lung J Clin Microbiol 27 1989 2014 2018
32. L. Berra, M.L. De, Z.X. Yu, P. Laquerriere, A. Baccarelli, and T. Kolobow Endotracheal tubes coated with antiseptics decrease bacterial colonization of the ventilator circuits, lungs, and endotracheal tube Anesthesiology 100 2004 1446 1456
33. R. Greene, S. Thompson, and H.S. Jantsch Detection of pooled secretions above endotracheal-tube cuffs: value of plain radiographs in sheep cadavers and patients AJR Am J Roentgenol 163 1994 1333 1337
34. P.V. O'Neal, M.J. Grap, C. Munro, P. Minick, and C. Sessler Factors associated with subglottic secretion accumulation and removal among mechanically ventilated adults Am J Crit Care 11 2002 290
35. P.J. Young, M. Rollinson, H. Downward, and S. Henderson Leakage of fluid past the tracheal tube cuff in a benchtop model Br J Anaesth 78 1997 557 562
36. O.C. Tablan, L.J. Anderson, N.H. Arden, R.F. Breiman, J.C. Butler, and M.M. McNeil Guideline for prevention of nosocomial pneumonia. The Hospital Infection Control Practices Advisory Committee Am J Infection Control 22 1994 247 292
37. J. Muscedere, P. Dodek, S. Keenan, R. Fowler, D. Cook, and D. Heyland Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: prevention J Crit Care 23 2008 126 137
38. V.G. Alexiou, V. Ierodiakonou, G. Dimopoulos, and M.E. Falagas Impact of patient position on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials J Crit Care 24 2009 515 522
39. M.H. Kollef Ventilator-associated pneumonia. A multivariate analysis JAMA 270 1993 1965 1970
40. D.E. Craven, L.M. Kunches, V. Kilinsky, D.A. Lichtenberg, B.J. Make, and W.R. McCabe Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation Am Rev Respir Dis 133 1986 792 796
41. A. Torres, J. Serra-Batlles, and E. Ros Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position Ann Intern Med 116 1992 540 543
42. M. Orozco-Levi, A. Torres, and M. Ferrer Semirecumbent position protects from pulmonary aspiration but not completely from gastroesophageal reflux in mechanically ventilated patients Am J Respir Crit Care Med 152 1995 1387 1390
43. N.A. Metheny, R.E. Clouse, Y.H. Chang, B.J. Stewart, D.A. Oliver, and M.H. Kollef Tracheobronchial aspiration of gastric contents in critically ill tube-fed patients: frequency, outcomes, and risk factors Crit Care Med 34 2006 1007 1015
44. M.B. Drakulovic, A. Torres, T.T. Bauer, J.M. Nicolas, S. Nogue, and M. Ferrer Supine body position as a risk factor for nosocomial pneumonia in mechanically venitlated patients: a randomised trial Lancet 354 1999 1851 1858
45. D.J. Cook, B.K. Reeve, and L.C. Scholes Histamine-2-receptor antagonists and antacids in the critically ill population: stress ulceration versus nosocomial pneumonia Infect Control Hosp Epidemiol 15 1994 437 442
46. F. Daschner, I. Kappstein, and I. Engels Stress ulcer prophylaxis and ventilation pneumonia: prevention by antibacterial cytoprotective agents? Infect Control Hosp Epidemiol 9 1988 59 65
47. L.G. Donowitz, M.C. Page, B.L. Mileur, and S.H. Guenthner Alteration of normal gastric flora in critical care patients receiving antacid and cimetidine therapy Infect Control 7 1986 23 26
48. D.J. Cook, B.K. Reeve, and G.H. Guyatt Stress ulcer prophylaxis in critically ill patients. Resolving discordant meta-analyses JAMA 275 1996 308 314
49. H.R. Collard, S. Saint, and M.A. Matthay Prevention of ventilator-associated pneumonia: an evidence-based systematic review Ann Intern Med 138 2003 494 501
50. R.H. Kallet, and T.E. Quinn The gastrointestinal tract and ventilator-associated pneumonia Respir Care 50 2005 910 921
51. S. Mallow, J.A. Rebuck, and T. Osler Do proton pump inhibitors increase the incidence of nosocomial pneumonia and related infectious complications when compared with histamine-2 receptor antagonists in critically ill trauma patients? Curr Surg 61 5 2004 452 458
52. I. Kantorova, P. Svoboda, and P. Scheer Stress ulcer prophylaxis in critically ill patients: a randomized controlled trial Hepatogastroenterology 51 57 2004 757 761
53. S.J. Herzig, M.D. Howell, L.H. Ngo, and E.R. Marcantonio Acid-suppressive medication use and the risk for hospital-acquired pneumonia JAMA 301 2009 2120 2128
54. A.J. DeRiso, J.S. Ladowski, T.A. Dillon, J.W. Justice, and A.C. Peterson Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery Am J Respir Crit Care Med 109 1996 1556 1561
55. S. Houston, P. Hougland, J.J. Anderson, M. LaRocco, V. Kennedy, and L.O. Gentry Effectiveness of 0.12% chlorhexidine gluconate oral rinse in reducing prevalence of nosocomial pneumonia in patients undergoing heart surgery Am J Crit Care 11 2002 567 570
56. F. Fourrier, D. Dubois, and P. Pronnier Effect of gingival and dental plaque antiseptic decontamination on nosocomial infections acquired in the intensive care unit: a double-blind placebo-controlled multicenter study Crit Care Med 33 2005 1728 1735
57. M. Koeman, A.J. van der Ven, and E. Hak Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia Am J Respir Crit Care Med 173 2006 1348 1355
58. P. Segers, R.G. Speekenbrink, D.T. Ubbink, M.L. van Ogtrop, and B.A. de Mol Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial JAMA 296 2006 2460 2466
59. E.Y. Chan, A. Ruest, M.O. Meade, and D.J. Cook Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis BMJ 334 2007 889
60. M.P. Chlebicki, and N. Safdar Topical chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis Crit Care Med 35 2007 595 602
61. C.L. Munro, and M.J. Grap Oral health and care in the intensive care unit: state of the science Am J Crit Care 13 2004 25 33
62. C.L. Munro, M.J. Grap, D. McClish, and C.N. Sessler Chlorhexidine reduces ventilator associated pneumonia (VAP) in mechanically ventilated ICU adults Crit Care Med 34 2006 Suppl A1
63. M.J. Grap, C.L. Munro, R.K. Elswick, C.N. Sessler, K.R. Ward, and S.M. Higgins Early, single chlorhexidine application to reduce oral flora and VAP in trauma victims Am J Crit Care 18 2009 200
64. V. Pacheco-Fowler, T. Gaonkar, P.C. Wyer, and S. Modak Antiseptic impregnated endotracheal tubes for the prevention of bacterial colonization J Hosp Infect 57 2004 170 174
65. M.E. Olson, B.G. Harmon, and M.H. Kollef Silver-coated endotracheal tubes associated with reduced bacterial burden in the lungs of mechanically ventilated dogs Am J Respir Crit Care Med 121 2002 863 870
66. J. Rello, M. Kollef, and E. Diaz Reduced burden of bacterial airway colonization with a novel silver-coated endotracheal tube in a randomized multiple-center feasibility study Crit Care Med 34 2006 2766 2772
67. M.H. Kollef, B. Afessa, and A. Anzueto Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial JAMA 300 2008 805 813
68. K.E. Burns, N.K. Adhikari, and M.O. Meade Noninvasive positive pressure ventilation as a weaning strategy for intubated adults with respiratory failure Cochrane Database Syst Rev 4 2003 CD004127
69. A. Esteban, F. Frutos-Vivar, and N.D. Ferguson Noninvasive positive-pressure ventilation for respiratory failure after extubation N Engl J Med 350 2004 2452 2460
70. O.C. Tablan, L.J. Anderson, R. Besser, C. Bridges, and R. Hajjeh Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee MMWR Recomm Rep 53 2004 1 36
71. American Thoracic Society; Infectious Diseases Society of America Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia Am J Respir Crit Care Med 171 2005 388 416
72. M.L. Sole, J.F. Byers, J.E. Ludy, and C.L. Ostrow Suctioning techniques and airway management practices: pilot study and instrument evaluation Am J Crit Care 11 2002 363 368
73. D.K. Heyland, D.J. Cook, and P.M. Dodek Prevention of ventilator-associated pneumonia: current practice in Canadian intensive care units J Crit Care 17 2002 161 167
74. K.L. Johnson, P.A. Kearney, S.B. Johnson, J.B. Niblett, N.L. MacMillan, and R.E. McClain Closed versus open endotracheal suctioning: costs and physiologic consequences Crit Care Med 22 1994 658 666
75. S.M. Maggiore, F. Lellouche, and J. Pigeot Prevention of endotracheal suctioning-induced alveolar derecruitment in acute lung injury Am J Respir Crit Care Med 167 2003 1215 1224
76. M. Cereda, F. Villa, E. Colombo, G. Greco, M. Nacoti, and A. Pesenti Closed system endotracheal suctioning maintains lung volume during volume-controlled mechanical ventilation Intensive Care Med 27 2001 648 654
77. S.A. Deppe, J.W. Kelly, and L.L. Thoi Incidence of colonization, nosocomial pneumonia, and mortality in critically ill patients using a Trach Care closed-suction system versus an open-suction system: prospective, randomized study Crit Care Med 18 1990 1389 1393
78. L. Lorente, M. Lecuona, M.M. Martin, C. Garcia, M.L. Mora, and A. Sierra Ventilator-associated pneumonia using a closed versus an open tracheal suction system Crit Care Med 33 2005 115 119
79. Siempos II, K.Z. Vardakas, and M.E. Falagas Closed tracheal suction systems for prevention of ventilator-associated pneumonia Br J Anaesth 100 2008 299 306
80. I.P. Jongerden, M.M. Rovers, M.H. Grypdonck, and M.J. Bonten Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a meta-analysis Crit Care Med 35 2007 260 270
81. M. Subirana, I. Sola, and S. Benito Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients Cochrane Database Syst Rev 4 2007 CD004581
82. R.P. Vonberg, T. Eckmanns, T. Welte, and P. Gastmeier Impact of the suctioning system (open vs. closed) on the incidence of ventilation-associated pneumonia: meta-analysis of randomized controlled trials Intensive Care Med 32 2006 1329 1335
83. B.S. Niel-Weise, R.L. Snoeren, and P.J. van den Broek Policies for endotracheal suctioning of patients receiving mechanical ventilation: a systematic review of randomized controlled trials Infect Control Hosp Epidemiol 28 2007 531 536
84. J. Rello, R. Sonora, P. Jubert, A. Artigas, M. Rue, and J. Valles Pneumonia in intubated patients: role of respiratory airway care Am J Respir Crit Care Med 154 1996 111 115
85. L.E. Simmons, and C.L. Scanlan Airway management A.R. Wilkins, J.K. Stoller, F.A. Scannapieco, Egan's fundamentals of respiratory care 2003 Mosby St. Louis, MO 653 704
86. M. Galinski, V. Treoux, B. Garrigue, F. Lapostolle, S.W. Borron, and F. Adnet Intracuff pressures of endotracheal tubes in the management of airway emergencies: the need for pressure monitoring Ann Emerg Med 47 2006 545 547
87. P. Dodek, S. Keenan, and D. Cook Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia Ann Intern Med 141 2004 305 313
88. M.H. Kollef, N.J. Skubas, and T.M. Sundt A randomized clinical trial of continuous aspiration of subglottic secretions in cardiac surgery patients Am J Respir Crit Care Med 116 1999 1339 1346
89. K. Smulders, H.H. van der, I. Weers-Pothoff, and C. Vandenbroucke-Grauls A randomized clinical trial of intermittent subglottic secretion drainage in patients receiving mechanical ventilation Am J Respir Crit Care Med 121 2002 858 862
90. J. Valles, A. Artigas, and J. Rello Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia Ann Intern Med 122 1995 179 186
91. C. Dezfulian, K. Shojania, H.R. Collard, H.M. Kim, M.A. Matthay, and S. Saint Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis Am J Med 118 2005 11 18
92. M.J. Grap, C.L. Munro, R.S. Hummel III, R.K. Elswick Jr., J.L. McKinney, and C.N. Sessler Effect of backrest elevation on the development of ventilator-associated pneumonia Am J Crit Care 14 2005 325 332
93. D. Evans The use of position during critical illness: current practice and review of the literature Aust Crit Care 7 1994 16 21
94. M.J. Grap, C.L. Munro, S. Bryant, and B. Ashtiani Predictors of backrest elevation in critical care Intensive Crit Care Nurs 19 2003 68 74
95. C.A. van Nieuwenhoven, C. Vandenbroucke-Grauls, and F.H. van Tiel Feasibility and effects of the semirecumbent position to prevent ventilator-associated pneumonia: a randomized study Crit Care Med 34 2006 396 402
96. D.J. Cook, M.O. Meade, L.E. Hand, and J.P. McMullin Toward understanding evidence uptake: semirecumbency for pneumonia prevention Crit Care Med 30 2002 1472 1477
97. Institute for Healthcare Improvement Implement the ventilator bundle 2006 Institute for Healthcare Improvement Cambridge, MA
98. D.L. Helman Jr., J.H. Sherner III, T.M. Fitzpatrick, M.E. Callender, and A.F. Shorr Effect of standardized orders and provider education on head-of-bed positioning in mechanically ventilated patients Crit Care Med 31 2003 2285 2290
99. G.A. Joiner, D. Salisbury, and G.E. Bollin Utilizing quality assurance as a tool for reducing the risk of nosocomial ventilatorassociated pneumonia Am J Med Qual 11 1996 100 103
100. J.E. Zack, T. Garrison, and E. Trovillion Effect of an education program aimed at reducing the occurrence of ventilator-associated pneumonia Crit Care Med 30 2002 2407 2412
101. R. Resar, P. Pronovost, C. Haraden, T. Simmonds, T. Rainey, and T. Nolan Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia Jt Comm J Qual Patient Saf 31 2005 243 248
102. E. Crunden, C. Boyce, H. Woodman, and B. Bray An evaluation of the impact of the ventilator care bundle Nurs Crit Care 10 2005 242 246
103. C.S. Cocanour, M. Peninger, and B.D. Domonoske Decreasing ventilator-associated pneumonia in a trauma ICU J Trauma 61 2006 122 129