Methods of Chlorhexidine Cleansing to Prevent Ventilator-Associated Pneumonia (VAP)
Status:
Completed
Trial end date:
2019-08-01
Target enrollment:
Participant gender:
Summary
Ventilator-associated pneumonia (VAP) is common in patients receiving mechanical ventilation,
and is associated with longer hospital stay, increased treatment costs, and higher rates of
morbidity and mortality . VAP is reported to occur in 8%-67% of mechanically ventilated
patients (20%-28% in most reports) and has a mortality rate of 24%-50%, which is 2-3 times
the mortality rate of mechanically ventilated patients without VAP. In patients infected by
multi-resistant bacteria, the mortality rate may be as high as 76%. The diagnosis, treatment,
and prevention of VAP are therefore important. Strategies for preventing VAP are crucial for
reducing medical costs and increasing survival rates in critically ill patients. These
strategies mainly involve a semi-reclining position with the head of the bed raised to at
least 30°-45°, oral care, suctioning of subglottic secretions, selective decontamination of
the digestive tract, proper hand washing, avoidance or reduction of proton pump inhibitors,
avoidance of excessive sedation, and control of plasma glucose levels.
At our center, VAP is mainly caused by bacterial colonization of the upper respiratory tract
via aspiration. This study will compare four interventions including oropharyngeal
decontamination and subglottic suctioning by bronchoscopy, with the aim of developing a
prevention strategy to minimize the development of VAP during mechanical ventilation.