Prävention der beatmungsassoziierten Pneumonie^[*]

Kernaussagen

• Die beatmungsassoziierte Pneumonie (VAP) ist die häufigste nosokomiale Infektion auf Intensivstationen und von großer medizinischer und ökonomischer Relevanz.

• Als wesentlicher Pathomechanismus gilt die Mikroaspiration. Übersedierung, unnötige Beatmung und die Vernachlässigung krankenhaushygienischer Präventionsmaßnahmen sind die wesentlichen Ursachen für die VAP.

• Zur Vermeidung der VAP stehen viele Interventionsmöglichkeiten mit unterschiedlicher Evidenz zur Verfügung.

• Besonders bewährt hat sich die Einführung einiger ausgewählter, evidenzbasierter Maßnahmen als Bündel.

• Bleibt trotz Ausschöpfung aller Basismaßnahmen die VAP-Rate hoch, kann man weitere Maßnahmen erwägen, wie z. B. subglottische Sekretabsaugung oder SOD bzw. SDD.

• Den Erfolg infektionspräventiver Maßnahmen sollte man durch die Teilnahme an Surveillanceprogrammen überprüfen (z. B. KISS).

^* Die Erstpublikation dieses Beitrags erschien in Krankenh hyg up2date 2012; 7 (4): 275–289. DOI: 10.1055/s-0032-1325954

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