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. 2018 May 21;8(1):65.
doi: 10.1186/s13613-018-0412-8.

Impact of a VAP bundle in Belgian intensive care units

Laurent Jadot  1 , Luc Huyghens  2 , Annick De Jaeger  3 , Marc Bourgeois  4 , Dominique Biarent  5 , Adeline Higuet  6 , Koen de Decker  7 , Margot Vander Laenen  8 , Baudewijn Oosterlynck  4 , Patrick Ferdinande  9 , Pascal Reper  10   11 , Serge Brimioulle  12 , Sophie Van Cromphaut  13 , Stéphane Clement De Clety  14 , Thierry Sottiaux  15 , Pierre Damas  16
Affiliations

Impact of a VAP bundle in Belgian intensive care units

Laurent Jadot et al. Ann Intensive Care. .

Abstract

Background: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign.

Methods: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients. For each of these, data about the application of the bundle and the possible treatment for VAP were recorded.

Results: Between 36.6 and 54.8% of the 120 Belgian ICUs participated in the successive surveys. While the characteristics of ventilated patients remained similar throughout the years, the percentage of ventilated patients and especially the duration of ventilation significantly decreased before and after the national VAP bundle campaign. Ventilator care also profoundly changed: Controlling cuff pressure, head positioning above 30° were obtained in more than 90% of cases. Oral care was more frequently performed within a day, using more concentrated solutions of chlorhexidine. Subglottic suctioning also was used but in only 24.7% of the cases in the last years. Regarding the prevalence of VAP, it significantly decreased from 28% of ventilated patients in 2010 to 10.1% in 2016 (p ≤ 0.0001).

Conclusion: Although a causal relationship cannot be inferred from these data, the successive surveys revealed a potential impact of the VAP bundle campaign on both the respiratory care of ventilated patients and the prevalence of VAP in Belgian ICUs encouraging them to follow the guidelines.

Keywords: Belgian ICUs; VAP; VAP bundle; VAP survey.

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Figures

Fig. 1
Fig. 1
Evolution of the number of ICU beds, patients and ventilated patients in participating ICUs
Fig. 2
Fig. 2
Percentage of ventilated patients treated for VAP the day of the survey
See this image and copyright information in PMC

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