1. Elevation of the head of the bed to 30-45 degrees:
This position helps prevent aspiration of gastric contents and reduces the risk of VAP by improving the drainage of respiratory secretions.
2. Daily assessment for readiness to extubate:
Assessing the patient's readiness for extubation on a daily basis can reduce the duration of mechanical ventilation, lowering the risk of VAP and other complications.
3. Daily sedation vacation and assessment of delirium:
Minimizing sedation and assessing for delirium can reduce the length of time a patient spends on a ventilator, decreasing the likelihood of VAP.
4. Peptic ulcer disease prophylaxis:
Prophylactic measures like proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) can help prevent stress-related mucosal damage and subsequent VAP.
5. Deep venous thrombosis (DVT) prophylaxis:
Preventing DVT with measures such as anticoagulant therapy or mechanical devices reduces the risk of VAP, as patients with DVT are more prone to VAP.
6. Oral care with chlorhexidine:
Regular oral care with chlorhexidine helps reduce the colonization of bacteria in the oral cavity, which can lead to VAP when aspirated into the lungs.
7. Regular respiratory therapy:
Consistent respiratory therapy, including chest physiotherapy and incentive spirometry, aids in maintaining lung function and preventing VAP.
8. Continuous cuff pressure monitoring:
Monitoring and maintaining appropriate cuff pressure in endotracheal tubes prevent microaspiration of secretions, a common cause of VAP.
9. Subglottic secretion drainage:
Special endotracheal tubes with subglottic suction ports facilitate the removal of secretions above the cuff, further reducing the risk of VAP.
10. Regular ventilator circuit changes:
Frequent changes of ventilator circuits help prevent bacterial colonization, ensuring the delivery of clean, uncontaminated air.
