Ventilator-Associated Events and Their Prevention

Noelle M Cocoros; Michael Klompas

doi:10.1016/j.idc.2016.07.002

Ventilator-Associated Events and Their Prevention

Infect Dis Clin North Am. 2016 Dec;30(4):887-908. doi: 10.1016/j.idc.2016.07.002.

Authors

Noelle M Cocoros¹, Michael Klompas²

Affiliations

¹ Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, 401 Park Street, Suite 401, Boston, MA 02215, USA.
² Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, 401 Park Street, Suite 401, Boston, MA 02215, USA; Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: mklompas@partners.org.

PMID: 27816142
DOI: 10.1016/j.idc.2016.07.002

Abstract

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.

Keywords: Infection control; Mechanical ventilation; Prevention; Quality improvement; Ventilator-associated events; Ventilator-associated pneumonia.

Publication types

Review

MeSH terms

Cross Infection
Humans
Pneumonia, Ventilator-Associated
Pulmonary Edema
Respiration, Artificial / adverse effects*
Ventilator-Induced Lung Injury*