There are substantial differences in prevention of Ventilator-associated pneumonia all over the globe with many of them emanating from differences in how medical literature is interpreted and also the medical practices employed. Strategies like maintenance of good hygiene have been reported to be very effective but the problem is that not many people use them. Thus, the discussion is dedicated on outlining strategies of VAP prevention.
Placing the patient in a semi-recumbent position has been demonstrated to be effective in preventing ventilator-associated pneumonia. However, this approach is not widely used because professionals in the health sector have not come to a consensus on the degree of head elevation. Some have given a range which is mainly from thirty to forty degrees but there are those who do not agreed with this.
Regardless of the height the bed has been raised to, the patient will fare on better with a raised bed than when the bed is flat. Thus, health care providers are encouraged to put this approach into place. Patients who have recently undergone neurosurgery, those with significant hypo-tension or have sustained certain fractures should be exempted from this approach as it will cause more harm than good.
Withdrawal of sedatives and a weaning assessment should be conducted on a daily basis and if possible twice in a day. According to research, avoiding prolonged intubation minimizes the chances of the patients suffering from VAP. Therefore, the patient should be given a break of about eight hours every day to observe how well he or she fairs without the drugs. Spontaneous trials when it comes to independent breathing should be focuses on too.
Continuously removing subglottic secretion is very helpful to patients at risk of VAP. Tubes are employed in achieving this. There are new tubes which have been fitted with isolated dorsal lumen to make the suctioning process easier. Early-generation tubes were reported to malfunction frequently even though they were cheap. The newer ones are coated with silver and are sold at slightly higher prices but the degree of their effectiveness is worth the extra cost.
Through research studies, it has been demonstrated that use of oral tubes does a better job in prevention of ventilator associated pneumonia than feeding tubes. The argument is that the former reduces the probability of sinusitis which is the leading cause of VAP in patients admitted in the ICU. Nasal tubes should only be used under special cases.
Using chlorhexidine in oral hygiene has been termed as beneficial in pneumonia prevention in patients on a ventilator. The literature focusing on this does not explain the mechanism of action of this measures but its benefits have been confirmed though research. All that has to be done is gum stimulation, oral washes and brushing the teeth using this solution. The practices are not expensive and they take a very short time. Care providers should do this for the benefit of their patients.
Provision of prophylaxis for stress ulcers has been recently cleared as an effective strategy in VAP avoidance. Sucrasulfate use has been confirmed to minimize VAP and gastric bleeding. Gastrointestinal bleeding is a major cause of ventilator-associated pneumonia though the mechanism through which this happens is not clearly outlined. Antacids, H2 blockers and PPIs produce a similar effect but research studies focusing on them have not received much attention.
Placing the patient in a semi-recumbent position has been demonstrated to be effective in preventing ventilator-associated pneumonia. However, this approach is not widely used because professionals in the health sector have not come to a consensus on the degree of head elevation. Some have given a range which is mainly from thirty to forty degrees but there are those who do not agreed with this.
Regardless of the height the bed has been raised to, the patient will fare on better with a raised bed than when the bed is flat. Thus, health care providers are encouraged to put this approach into place. Patients who have recently undergone neurosurgery, those with significant hypo-tension or have sustained certain fractures should be exempted from this approach as it will cause more harm than good.
Withdrawal of sedatives and a weaning assessment should be conducted on a daily basis and if possible twice in a day. According to research, avoiding prolonged intubation minimizes the chances of the patients suffering from VAP. Therefore, the patient should be given a break of about eight hours every day to observe how well he or she fairs without the drugs. Spontaneous trials when it comes to independent breathing should be focuses on too.
Continuously removing subglottic secretion is very helpful to patients at risk of VAP. Tubes are employed in achieving this. There are new tubes which have been fitted with isolated dorsal lumen to make the suctioning process easier. Early-generation tubes were reported to malfunction frequently even though they were cheap. The newer ones are coated with silver and are sold at slightly higher prices but the degree of their effectiveness is worth the extra cost.
Through research studies, it has been demonstrated that use of oral tubes does a better job in prevention of ventilator associated pneumonia than feeding tubes. The argument is that the former reduces the probability of sinusitis which is the leading cause of VAP in patients admitted in the ICU. Nasal tubes should only be used under special cases.
Using chlorhexidine in oral hygiene has been termed as beneficial in pneumonia prevention in patients on a ventilator. The literature focusing on this does not explain the mechanism of action of this measures but its benefits have been confirmed though research. All that has to be done is gum stimulation, oral washes and brushing the teeth using this solution. The practices are not expensive and they take a very short time. Care providers should do this for the benefit of their patients.
Provision of prophylaxis for stress ulcers has been recently cleared as an effective strategy in VAP avoidance. Sucrasulfate use has been confirmed to minimize VAP and gastric bleeding. Gastrointestinal bleeding is a major cause of ventilator-associated pneumonia though the mechanism through which this happens is not clearly outlined. Antacids, H2 blockers and PPIs produce a similar effect but research studies focusing on them have not received much attention.
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