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J Crit Care. 2011 Feb;26(1):3-10. doi: 10.1016/j.jcrc.2010.04.001.

A European care bundle for management of ventilator-associated pneumonia.

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  • 1Critical Care Department, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron-Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain. jrello.hj23.ics@gencat.cat

Abstract

BACKGROUND:

Although there is a wealth of guidance concerning the management of patients with ventilator-associated pneumonia (VAP), compliance with recommendations concerning optimal treatment practices is highly variable.

METHODS:

This document presents a comprehensive care bundle package addressing all aspects of VAP diagnosis and treatment in an attempt to promote guideline-compliant practices. Uniquely, the development of these care bundles used a formalized method to assess the supporting data, based on multicriteria decision analysis.

RESULTS:

This system allowed the numerous VAP management parameters identified from recent European guidelines to be ranked according to defined criteria. The resulting VAP care bundles are (a) diagnosis: early chest x-rays within 1 hour, immediate reporting of respiratory secretions Gram staining, and (b) therapy: immediate treatment, empiric therapy based on local pathogens and risk factors, de-escalation, assessment of response within 72 hours, and short therapy duration if feasible.

CONCLUSION:

Adoption of these care bundles should rationalize VAP management practices and facilitate the development of consistent and guideline-compliant care processes.

Copyright © 2011 Elsevier Inc. All rights reserved.

PMID:
20537504
[PubMed - indexed for MEDLINE]
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