Updated Guidelines on Ventilator Use for Pneumonia

A joint update to recommendations on the prevention of ventilator-associated pneumonia (VAP), ventilator-associated events (VAE), and nonventilator hospital acquired pneumonia (NV-HAP) has been issued by the Society for Healthcare Epidemiology, the Infectious Diseases Society of America, the American Hospital Association, and the Association for Professionals in Infection Control and Epidemiology.

This update to the groups’ prior 2014 recommendations come as the second update in their series of recommendations for infection control in acute-care hospitals for adults, children, and neonates.

The recommendations that the group deemed essential practices include:

• Use of high flow nasal oxygen or noninvasive positive pressure ventilation to avoid intubation in adults and children
• Use of nasal continuous positive airway pressure ventilation or noninvasive positive pressure ventilation to avoid intubation in preterm neonates
• Use of multimodal strategies, medications (not including benzodiazepines), and sedation protocols such as spontaneous awakening trials to manage agitation and minimize sedation in adults
• Use of caffeine therapy to minimize ventilation duration in preterm neonates
• Use of regular oral care, early mobilization, and management of dysphagia to avoid NV-HAP

“Prevention of VAP, VAE, and NV-HAP requires implementing best practices to reduce the risk of infection and nurturing a culture that supports implementation,” the Compendium Expert Panel concluded. “Accountability is an essential principle for preventing health care associated infections.”

—Leigh Precopio

Reference:

Klompas M, Branson R, Cawcutt K, et al. Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 update. Cambridge University Press. Published online May 20, 2022.