Preventing VAP in the Intubated ED Patient

• Ventilator-associated pneumonia (VAP) occurs in 9-27% of patients receiving mechanical ventilation (MV).
• VAP increases the duration of MV and increases the ICU length of stay.
• VAP is primarily caused by aspiration of oropharyngeal secretions either during intubation or while receiving MV.
• While there are many interventions that may potentially reduce the incidence of VAP (aspiration of subglottic secretions, selective digestive decontamination, monitoring endotracheal cuff pressure), a simple, no cost intervention is patient positioning.
• Placing intubated patients in the semirecumbent position is associated with a lower risk of VAP.

References

Ramirez P, et al. Measures to prevent nosocomial infections during mechanical ventilation. Curr Opin Crit Care 2012;18:86-92.