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.
