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. 2021 Nov;36(4):294-299.
doi: 10.4266/acc.2021.00983. Epub 2021 Nov 23.

Effect of modified care bundle for prevention of ventilator-associated pneumonia in critically-ill neurosurgical patients

Suphannee Triamvisit  1 , Wassana Wongprasert  1 , Chalermwoot Puttima  1 , Matchima Na Chiangmai  1 , Nawaphan Thienjindakul  1 , Laksika Rodkul  1 , Chumpon Jetjumnong  2
Affiliations

Effect of modified care bundle for prevention of ventilator-associated pneumonia in critically-ill neurosurgical patients

Suphannee Triamvisit et al. Acute Crit Care. 2021 Nov.

Abstract

Background: Care bundles for ventilator-associated pneumonia (VAP) have been shown to minimize the rate of VAP in critically ill patients. Standard care bundles may need to be modified in resource-constrained situations. The goal of this study was to see if our modified VAP-care bundles lowered the risk of VAP in neurosurgical patients.

Methods: A prospective cohort study was conducted in mechanically ventilated neurosurgical patients. The VAP bundle was adjusted in the cohort group by increasing the frequency of intermittent endotracheal tube cuff pressure monitoring to six times a day while reducing oral care with 0.12% chlorhexidine to three times a day. The rate of VAP was compared to the historical control group.

Results: A total of 146 and 145 patients were enrolled in control and cohort groups, respectively. The mean age of patients was 52±16 years in both groups (P=0.803). The admission Glasgow coma scores were 7.79±2.67 and 7.80±2.77 in control and cohort group, respectively (P=0.969). VAP was found in nine patients in control group but only one patient in cohort group. The occurrence rate of VAP was significantly reduced in cohort group compared to control group (0.88/1,000 vs. 6.84/1,000 ventilator days, P=0.036).

Conclusions: The modified VAP bundle is effective in lowering the VAP rate in critically ill neurosurgical patients. It requires low budget and manpower and can be employed in resource-constrained settings.

Keywords: chlorhexidine; critical care; intubation; neurosurgery; oral hygiene; ventilator-associated pneumonia.

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Conflict of interest statement

CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Hand pressure gauge manometer.
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References

    1. Rello J, Ollendorf DA, Oster G, Vera-Llonch M, Bellm L, Redman R, et al. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest. 2002;122:2115–21. - PubMed
    1. Craven DE. Epidemiology of ventilator-associated pneumonia. Chest. 2000;117(4 Suppl 2):186S–187S. - PubMed
    1. Martin-Loeches I, Rodriguez AH, Torres A. New guidelines for hospital-acquired pneumonia/ventilator-associated pneumonia: USA vs. Europe. Curr Opin Crit Care. 2018;24:347–52. - PubMed
    1. Triamvisit S, Maneewan C, Bunturat P, Wongprasert W, Limpassatan K, Kasatpibal N, et al. Results of an evidence-based care bundle for reducing ventilator-associated pneumonia (VAP) in neurosurgical patients. J Med Assoc Thai. 2016;99:1014–9. - PubMed
    1. Lorente L, Lecuona M, Jiménez A, Lorenzo L, Roca I, Cabrera J, et al. Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. Crit Care. 2014;18:R77. - PMC - PubMed

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