Non-Pharmacologic Measures to Prevent VAP

• Ventilator-associated pneumonia (VAP) is one of the most common complications of mechanical ventilation and is associated with significant increases in morbidity and mortality.
• With the persistence of the boarding crisis, many critically ill intubated patients remain in EDs for extended periods of time, thereby increasing their length of stay, morbidity, and mortality.
• For the critically ill intubated patient, consider implementing the following non-pharmacologic interventions that have been shown to decrease the incidence of VAP:
  • Strict hand hygiene compliance
  • Elevating the head of the bed to 45 degrees, unless contraindicated
  • Utilize endotracheal tubes with subglottic secretion drainage
• The following interventions have not been consistently shown to reduce VAP:
  • Continuous endotracheal cuff monitoring
  • Closed endotracheal suctioning systems
  • Silver-coated endotracheal tubes

References

Krone M, Seeber C, Nydahl P. What's New in Intensive Care: Preventing Ventilator-Associated Pneumonia Non-Pharmacologically. Intensive Care Med. 2024; 50:2185-2187.