Ventilator-Associated Events and Their Prevention

被引:20
作者
Cocoros, Noelle M. [1 ]
Klompas, Michael [1 ,2 ]
机构
[1] Harvard Med Sch, Harvard Pilgrim Hlth Care Inst, Dept Populat Med, 401 Pk St,Suite 401, Boston, MA 02215 USA
[2] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA
基金
美国医疗保健研究与质量局;
关键词
Ventilator-associated events; Ventilator-associated pneumonia; Mechanical ventilation; Quality improvement; Infection control; Prevention; CRITICALLY-ILL PATIENTS; SUBGLOTTIC SECRETION DRAINAGE; INTENSIVE-CARE-UNIT; RECEIVING MECHANICAL VENTILATION; RESPIRATORY-DISTRESS-SYNDROME; INDIVIDUAL PATIENT DATA; LONG-TERM MORTALITY; FOR-DISEASE-CONTROL; LENGTH-OF-STAY; SELECTIVE DECONTAMINATION;
D O I
10.1016/j.idc.2016.07.002
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The Centers for Disease Control and Prevention shifted the focus of safety surveillance in mechanically ventilated patients from ventilator-associated pneumonia to ventilator-associated events (VAEs) in 2013. The shift was designed to increase the objectivity and reproducibility of surveillance and to encourage quality-improvement programs to tackle a broader array of complications in mechanically ventilated patients. Prospective intervention studies have found that minimizing sedation, increasing the use of spontaneous awakening and breathing trials, and conservative fluid management can lower VAE rates and decrease duration of mechanical ventilation. Additional strategies to prevent VAEs include early mobility programs, low tidal volume ventilation, and restrictive transfusion thresholds.
引用
收藏
页码:887 / +
页数:24
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