Prävention der beatmungsassoziierten Pneumonie

Die beatmungsassoziierte Pneumonie (Ventilator-associated Pneumonia, VAP) ist die häufigste nosokomiale Infektion in der Intensivmedizin und stellt eine relevante Komplikation im Rahmen der maschinellen Beatmung dar. Maßnahmen zur Prävention einer VAP gehören daher zur Standardbehandlung beatmeter Patienten.

Schlüsselwörter

Intensivmedizin - Beatmung - ventilatorassoziierte Pneumonie - VAP

• Literatur

• 1 Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen – NRZ. Infektions-Surveillance. Im Internet (Stand: 09.12.2020): https://www.nrz-hygiene.de/surveillance/kiss/its-kiss/infektionen
• 2 Dudeck MA, Horan TC, Peterson KD. et al. National Healthcare Safety Network report, data summary for 2011, device-associated module. Am J Infect Control 2013; 41: 286-300 doi:10.1016/j.ajic.2013.01.002
• 3 Koulenti D, Tsigou E, Rello J. Nosocomial pneumonia in 27 ICUs in Europe: perspectives from the EU-VAP/CAP study. Eur J Clin Microbiol Infect Dis 2017; 36: 1999-2006 doi:10.1007/s10096-016-2703-z
• 4 Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med 2020; 46: 888-906 doi:10.1007/s00134-020-05980-0
• 5 Ferrer M, Torres A. Epidemiology of ICU-acquired pneumonia. Curr Opinion Crit Care 2018; 24: 325-331 doi:10.1097/mcc.0000000000000536
• 6 Gastmeier P, Sohr D, Geffers C. et al. Early- and late-onset pneumonia: is this still a useful classification?. Antimicrob Agents Chemother 2009; 53: 2714-2718 doi:10.1128/aac.01070-08
• 7 Magill SS, Klompas M, Balk R. et al. Developing a new national approach to surveillance for ventilator-associated events: executive summary. Am J Infect Control 2013; 41: 1096-1099 doi:10.1016/j.ajic.2013.07.001
• 8 Shorr AF, Sherner JH, Jackson WL. et al. Invasive approaches to the diagnosis of ventilator-associated pneumonia: a meta-analysis. Crit Care Med 2005; 33: 46-53 doi:10.1097/01.ccm.0000149852.32599.31
• 9 Berton DC, Kalil AC, Teixeira PJ. Quantitative versus qualitative cultures of respiratory secretions for clinical outcomes in patients with ventilator-associated pneumonia. Cochrane Database Syst Rev 2014; (10) CD006482
• 10 Kohlenberg A, Schwab F, Behnke M. et al. Pneumonia associated with invasive and noninvasive ventilation: an analysis of the German nosocomial infection surveillance system database. Intensive Care Med 2010; 36: 971-978 doi:10.1007/s00134-010-1863-z
• 11 Gil-Perotin S, Ramirez P, Marti V. et al. Implications of endotracheal tube biofilm in ventilator-associated pneumonia response: a state of concept. Crit Care 2012; 16: R93 doi:10.1186/cc11357
• 12 Fàbregas N, Torres A, El-Ebiary M. et al. Histopathologic and microbiologic aspects of ventilator-associated pneumonia. Anesthesiology 1996; 84: 760-771 doi:10.1097/00000542-199604000-00002
• 13 Roquilly A, Marret E, Abraham E. et al. Pneumonia prevention to decrease mortality in intensive care unit: a systematic review and meta-analysis. Clin Infect Dis 2015; 60: 64-75 doi:10.1093/cid/ciu740
• 14 Letchford E, Bench S. Ventilator-associated pneumonia and suction: a review of the literature. Brit J Nurs 2018; 27: 13-18 doi:10.12968/bjon.2018.27.1.13
• 15 Manzano F, Fernández-Mondéjar E, Colmenero M. et al. Positive-end expiratory pressure reduces incidence of ventilator-associated pneumonia in nonhypoxemic patients. Crit Care Med 2008; 36: 2225-2231 doi:10.1097/CCM.0b013e31817b8a92
• 16 Pozuelo-Carrascosa DP, Herráiz-Adillo Á, Alvarez-Bueno C. et al. Subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of systematic reviews and an updated meta-analysis. Eur Respirat Rev 2020; 29: 190107 doi:10.1183/16000617.0107-2019
• 17 Oostdijk EAN, Kesecioglu J, Schultz MJ. et al. Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial. JAMA 2014; 312: 1429-1437 doi:10.1001/jama.2014.7247
• 18 Plantinga NL, de Smet A, Oostdijk EAN. et al. Selective digestive and oropharyngeal decontamination in medical and surgical ICU patients: individual patient data meta-analysis. Clin Microbiol Infect 2018; 24: 505-513 doi:10.1016/j.cmi.2017.08.019
• 19 Mirtalaei N, Farazi A, Ebrahimi Monfared M. et al. Efficacy of antibiotic prophylaxis against ventilator-associated pneumonia. J Hosp Infect 2019; 101: 272-275 doi:10.1016/j.jhin.2018.08.017
• 20 François B, Cariou A, Clere-Jehl R. et al. Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest. N Engl J Med 2019; 381: 1831-1842 doi:10.1056/NEJMoa1812379
• 21 Póvoa FCC, Cardinal-Fernandez P, Maia IS. et al. Effect of antibiotics administered via the respiratory tract in the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis. J Crit Care 2018; 43: 240-245 doi:10.1016/j.jcrc.2017.09.019
• 22 Lee S, Lighvan NL, McCredie V. et al. Chlorhexidine-related mortality rate in critically ill subjects in intensive care units: a systematic review and meta-analysis. Respirat Care 2019; 64: 337-349 doi:10.4187/respcare.06434
• 23 Su M, Jia Y, Li Y. et al. Probiotics for the prevention of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials. Respirat Care 2020; 65: 673-685 doi:10.4187/respcare.07097
• 24 Tokmaji G, Vermeulen H, Müller MC. et al. Silver-coated endotracheal tubes for prevention of ventilator-associated pneumonia in critically ill patients. Cochrane Database Syst Rev 2015; (08) CD009201
• 25 Pinciroli R, Mietto C, Piriyapatsom A. et al. endotracheal tubes cleaned with a novel mechanism for secretion removal: a randomized controlled clinical study. Respirat Care 2016; 61: 1431-1439 doi:10.4187/respcare.04363
• 26 Pirrone M, Imber DA, Marrazzo F. et al. Silver-coated endotracheal tubes cleaned with a mechanism for secretion removal. Respirat Care 2019; 64: 1-9 doi:10.4187/respcare.06222
• 27 Wang Y, Ge L, Ye Z. et al. Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: an updated systematic review and network meta-analysis of randomized trials. Intensive Care Med 2020;
• 28 Wang L, Li X, Yang Z. et al. Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation. Cochrane Database Syst Rev 2016; (01) CD009946
• 29 Li Bassi G, Panigada M, Ranzani OT. et al. Randomized, multicenter trial of lateral Trendelenburg versus semirecumbent body position for the prevention of ventilator-associated pneumonia. Intensive Care Med 2017; 43: 1572-1584 doi:10.1007/s00134-017-4858-1
• 30 Ayzac L, Girard R, Baboi L. et al. Ventilator-associated pneumonia in ARDS patients: the impact of prone positioning. A secondary analysis of the PROSEVA trial. Intensive Care Med 2016; 42: 871-878 doi:10.1007/s00134-015-4167-5
• 31 Mounier R, Adrie C, Français A. et al. Study of prone positioning to reduce ventilator-associated pneumonia in hypoxaemic patients. Eur Respirat J 2010; 35: 795-804 doi:10.1183/09031936.00057509
• 32 Staudinger T, Bojic A, Holzinger U. et al. Continuous lateral rotation therapy to prevent ventilator-associated pneumonia. Crit Care Med 2010; 38: 486-490 doi:10.1097/CCM.0b013e3181bc8218
• 33 Wang MY, Pan L, Hu XJ. Chest physiotherapy for the prevention of ventilator-associated pneumonia: A meta-analysis. Am J Infect Control 2019; 47: 755-760 doi:10.1016/j.ajic.2018.12.015
• 34 Blot SI, Rello J, Koulenti D. The value of polyurethane-cuffed endotracheal tubes to reduce microaspiration and intubation-related pneumonia: a systematic review of laboratory and clinical studies. Crit Care 2016; 20: 203 doi:10.1186/s13054-016-1380-8
• 35 Huang WM, Huang XA, Du YP. et al. Tapered Cuff versus Conventional Cuff for Ventilator-Associated Pneumonia in Ventilated Patients: A Meta-Analysis of Randomized Controlled Trials. Can Respirat J 2019; 2019: 7876417 doi:10.1155/2019/7876417
• 36 Wen Z, Wei L, Chen J. et al. Is continuous better than intermittent control of tracheal cuff pressure? A meta-analysis. Nurs Crit Care 2019; 24: 76-82 doi:10.1111/nicc.12393
• 37 Khan R, Al-Dorzi HM, Al-Attas K. et al. The impact of implementing multifaceted interventions on the prevention of ventilator-associated pneumonia. Am J Infect Control 2016; 44: 320-326 doi:10.1016/j.ajic.2015.09.025