Conoscenze teorico-pratiche degli infermieri di terapia intensiva in merito alla prevenzione delle Ventilatory-Associated-Pneumonia (VAP): indagine conoscitiva multicentrica

Alessandro Aguzzi, Federica Menichini, Marco Iacoucci

Abstract

La polmonite associata a ventilazione meccanica (VAP) è un’infezione a carico dei polmoni, che insorge in pazienti intubati e sottoposti a ventilazione meccanica da almeno 48 ore. Questa infezione è una frequente complicanza ospedaliera (incidenza del 9-27%) ed è fondamentale prevenirla, in quanto il tasso di mortalità ad essa correlato è del 33-50%; è associata, inoltre, a costi elevati per le aziende ospedaliere. Lo scopo dell’indagine è individuare le c

Riferimenti bibliografici

Kalanuria, A.A., Zai, W. & Mirski, M. Ventilator-associated pneumonia in the ICU. Crit Care 18, 208 (2014). https://doi.org/10.1186/cc13775

Keyt H, Faverio P, Restrepo MI. Prevention of ventilator-associated pneumonia in the intensive care unit: a review of the clinically relevant recent advancements. Indian J Med Res. 2014;139(6):814-821.

Ibn Saied W, Souweine B, Garrouste-Orgeas M, et al. Respective impact of implementation of prevention strategies, colonization with multiresistant bacteria and antimicrobial use on the risk of early- and late-onset VAP: An analysis of the OUTCOMEREA network. PLoS One. 2017;12(11):e0187791. Published 2017 Nov 29. doi:10.1371/journal.pone.0187791

Khaky B, Yazdannik A, Mahjobipoor H. Evaluating the Efficacy of Nanosil Mouthwash on the Preventing Pulmonary Infection in Intensive Care Unit: a Randomized Clinical Trial. Med Arch. 2018;72(3):206-209. doi:10.5455/medarh.2018.72.206-209

Kollef MH, Hamilton CW, Ernst FR. Economic impact of ventilator-associated pneumonia in a large matched cohort. Infect Control Hosp Epidemiol. 2012;33(3):250-256. doi:10.1086/664049

Bell L. Using Endotracheal Suctioning For Patients. Am J Crit Care. 2015;24(4):326. doi:10.4037/ajcc2015597

Agency for Clinical Innovation (ACI). Suctioning an Adult ICU Patient with an Artificial Airway: A Clinical Practice Guideline. IC Manual: best practice guidelines for intensive care. Ed. 2014. [online] https://www.aci.health.nsw.gov.au/networks/icnsw/intensive-care-manual/statewide-guidelines/suctioning-an-adult-icu-patient (02/07/2020)

Veitz-Keenan A, Ferraiolo DM. Oral care with chlorhexidine seems effective for reducing the incidence of ventilator-associated pneumonia. Evid Based Dent. 2017;18(4):113-114. doi:10.1038/sj.ebd.6401272

de Lacerda Vidal CF, Vidal AK, Monteiro JG Jr, et al. Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator-associated pneumonia: a randomized study [published correction appears in BMC Infect Dis. 2017 Feb 27;17 (1):173]. BMC Infect Dis. 2017;17(1):112. Published 2017 Jan 31. doi:10.1186/s12879-017-2188-0

Enwere EN, Elofson KA, Forbes RC, Gerlach AT. Impact of chlorhexidine mouthwash prophylaxis on probable ventilator-associated pneumonia in a surgical intensive care unit. Int J Crit Illn Inj Sci. 2016;6(1):3-8. doi:10.4103/2229-5151.177368

Zhang TT, Tang SS, Fu LJ. The effectiveness of different concentrations of chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. J Clin Nurs. 2014;23(11-12):1461-1475. doi:10.1111/jocn.12312

Boltey E, Yakusheva O, Costa DK. 5 Nursing strategies to prevent ventilator-associated pneumonia. Am Nurse Today. 2017;12(6):42-43.

Marjanovic N, Frasca D, Asehnoune K, et al. Multicentre randomised controlled trial to investigate the usefulness of continuous pneumatic regulation of tracheal cuff pressure for reducing ventilator-associated pneumonia in mechanically ventilated severe trauma patients: the AGATE study protocol. BMJ Open. 2017;7(8):e017003. Published 2017 Aug 7. doi:10.1136/bmjopen-2017-017003

Danielis M, Benatti S, Celotti P, De Monte A, Trombini O. Il monitoraggio pressorio continuo della cuffia del tubo endotracheale: best practice in terapia intensiva [Continuous monitoring of endotracheal tube cuff pressure: best practice in intensive care unit]. Assist Inferm Ric. 2015;34(1):15-20. doi:10.1702/1812.19746

Ramirez P, Bassi GL, Torres A. Measures to prevent nosocomial infections during mechanical ventilation. Curr Opin Crit Care. 2012;18(1):86-92. doi:10.1097/MCC.0b013e32834ef3ff

Osti C, Wosti D, Pandey B, Zhao Q. Ventilator-Associated Pneumonia and Role of Nurses in Its Prevention. JNMA J Nepal Med Assoc. 2017;56(208):461-468.

American Association for Respiratory Care. AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Respir Care. 2010;55(6):758-764.

Chacko R, Rajan A, Lionel P, Thilagavathi M, Yadav B, Premkumar J. Oral decontamination techniques and ventilator-associated pneumonia. Br J Nurs. 2017;26(11):594-599. doi:10.12968/bjon.2017.26.11.594

Koeman M, van der Ven AJ, Hak E, et al. Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia. Am J Respir Crit Care Med. 2006;173(12):1348-1355. doi:10.1164/rccm.200505-820OC

Price R, MacLennan G, Glen J; SuDDICU Collaboration. Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis. BMJ. 2014;348:g2197. Published 2014 Mar 31. doi:10.1136/bmj.g2197

Mietto C, Pinciroli R, Patel N, Berra L. Ventilator associated pneumonia: evolving definitions and preventive strategies. Respir Care. 2013;58(6):990-1007. doi:10.4187/respcare.02380

Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogué S, Ferrer M. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial. Lancet. 1999;354(9193):1851-1858. doi:10.1016/S0140-6736(98)12251-1

van Nieuwenhoven CA, Vandenbroucke-Grauls C, van Tiel FH, et al. Feasibility and effects of the semirecumbent position to prevent ventilator-associated pneumonia: a randomized study. Crit Care Med. 2006;34(2):396-402. doi:10.1097/01.ccm.0000198529.76602.5e

Keeley L. Reducing the risk of ventilator-acquired pneumonia through head of bed elevation. Nurs Crit Care. 2007;12(6):287-294. doi:10.1111/j.1478-5153.2007.00247.x

Giusti GD, Rogari C, Gili A, Nisi F. Cuff pressure monitoring by manual palpation in intubated patients: How accurate is it? A manikin simulation study. Aust Crit Care. 2017;30(4):234-238. doi:10.1016/j.aucc.2016.10.001

Biondino A., Scagnetti T. Assistenza Respiratoria Domiciliare – Il paziente adulto tracheostomizzato in ventilazione meccanica a lungo termine. Ed Universitalia, 2013.

Di Muzio M, Cammilletti V, Petrelli E, Di Simone E. Hand hygiene in preventing nosocomial infections:a nursing research. Ann Ig. 2015;27(2):485-491. doi:10.7416/ai.2015.2035

Marini AL, Khan R, Mundekkadan S. Multifaceted bundle interventions shown effective in reducing VAP rates in our multidisciplinary ICUs. BMJ Qual Improv Rep. 2016;5(1):u205566.w2278. Published 2016 Apr 4. doi:10.1136/bmjquality.u205566.w2278

Jadot L, Huyghens L, De Jaeger A, et al. Impact of a VAP bundle in Belgian intensive care units. Ann Intensive Care. 2018;8(1):65. Published 2018 May 21. doi:10.1186/s13613-018-0412-8

Refback

  • Non ci sono refbacks, per ora.