Surveillance and prevention of healthcare-associated infections: best practices to prevent ventilator-associated events

ABSTRACT

Introduction

Ventilator associated pneumonia (VAP) leads to an increase in morbidity, mortality, and healthcare costs. In addition to increased evidence from the latest European and American guidelines (published in 2017 and 2022, respectively), in the last two years, several important clinical experiences have added new prevention tools to be included to improve the management of VAP.

Areas covered

This paper is a narrative review of new evidence on VAP prevention. We divided VAP prevention measures into pharmacological, non-pharmacological, and ventilator care bundles.

Expert opinion

Most of the effective strategies that have been shown to decrease the incidence of complications are easy to implement and inexpensive. The implementation of care bundles, accompanied by educational measures and a multidisciplinary team should be part of optimal management. In addition to ventilator care bundles for the prevention of VAP, it could possibly be beneficial to use ventilator care bundles for the prevention of noninfectious ventilator associated events.

KEYWORDS:

• Ventilator associated pneumonia
• ventilator associated events
• prevention
• measures
• pharmacologic
• non-pharmacologic
• care bundles

Article highlights

• Prevention of ventilator-associated pneumonia should be an integral part of safety programs, especially among episodes categorized as ventilator-associated events.

• Ventilator-associated pneumonia and ventilator-associated events have many differences and prevention strategies need to be different.

• Reducing the ventilator period through awakening tests, short-term sedatives and early mobilization whenever possible is required to prevent ventilator-associated events.

• A multidisciplinary approach for ventilator-associated event prevention should focus on the reduction of the exposure to mechanical ventilation.

• Prevention measures are cost-effective, with education serving as a cornerstone for implementing prevention care bundles effectively.

• Artificial intelligence and machine learning will play an important role in the early identification of ventilator-associated events and infectious ventilator-associated complications among ventilated patients.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.