Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: Prevention☆

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Abstract

Background

Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in ventilated critically ill patients.

Purpose

To develop evidence-based guidelines for the prevention of VAP.

Data Sources

MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews and Register of Controlled Trials.

Study Selection

The authors systematically searched for all relevant randomized, controlled trials and systematic reviews on the topic of prevention of VAP in adults that were published from 1980 to October 1, 2006.

Data Extraction

Independently and in duplicate, the panel scored the internal validity of each trial. Effect size, confidence intervals, and homogeneity of the results were scored using predefined definitions. Scores for the safety, feasibility, and economic issues were assigned based on consensus of the guideline panel.

Levels of Evidence

The following statements were used: recommend, consider, do not recommend, and no recommendation due to insufficient or conflicting evidence.

Data Synthesis

To prevent VAP:

Conclusion

There are a growing number of evidence-based strategies for VAP prevention, which, if applied in practice, may reduce the incidence of this serious nosocomial infection.

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