Abstract
Ventilator-associated pneumonia (VAP) is a common and serious complication of mechanical ventilation via an artificial airway. As with all nosocomial infections, VAP increases costs, morbidity, and mortality in the intensive care unit (ICU). VAP prevention is a multifaceted priority of the intensive care team, and can include the use of specialized artificial airways and heat-and-moisture exchangers (HME). Substantial evidence supports the use of endotracheal tubes (ETTs) that allow subglottic suctioning; silver-coated and antiseptic-impregnated ETTs; ETTs with thin-walled polyurethane cuffs; and HMEs, but these devices also can have adverse effects. Controversy still exists regarding the evidence, cost-effectiveness, and disadvantages and risks of these devices.
- ventilator-associated pneumonia
- VAP
- heat-and-moisture exchanger
- nosocomial pneumonia
- subglottic secretion removal
- polyurethane cuff
- endotracheal tube
- silver-coated
- heat-and-moisture exchanger
Footnotes
- Correspondence: Michael A Gentile RRT FAARC, Division of Pulmonary and Critical Care Medicine, Box 3911, Duke University Medical Center, Durham NC 27710. E-mail: michael.gentile{at}duke.edu.
Mr Gentile and Mr Siobal presented a version of this paper at the 44th Respiratory Care Journal Conference, “Respiratory Care Controversies II,” held March 13-15, 2009, in Cancún, Mexico.
The authors have disclosed no conflicts of interest.
- Copyright © 2010 by Daedalus Enterprises
