VAP - VAP Recommendations

VAP Clinical Practice Guidelines

Published VAP Clinical Practice Guidelines:

Prevention Full Text pdf (with permission from Elsevier)
Diagnosis & Treatment Full Text pdf (with permission from Elsevier)

Protocol: The Development of Comprehensive Clinical Practice Guidelines for the Prevention, Diagnosis and Treatment of Ventilator Associated Pneumonia. Link

Summary of Recommendations Link

Topics

Click on a strategy to view the associated tables of evidence.

Prevention

1.0 Physical Strategies

1.1 Route of endotracheal intubation

1.2 Systematic search for maxillary sinusitis

1.3 Frequency of ventilator circuit changes

1.4 Type of airway humidification

1.5 Frequency of change of airway humidification

1.6 Type of endotracheal suctioning system (Open v Closed)

1.7 Frequency of change of endotracheal suctioning system

1.8 Subglottic secretion drainage

1.9 Timing of tracheostomy

1.10 Bacterial filters

2.0 Positional Strategies

2.1 Rotating beds

2.2 Semi-recumbent positioning

2.3 Prone positioning

3.0 Pharmacological Strategies

3.1 Prophylactic antibiotics

3.1a Aerosolized antibiotics

3.1b Nasal antibiotics

3.1c Intravenous antibiotics alone

3.1d Topical/Topical plus intravenous antibiotics

3.2 Oral antiseptic

3.2a Chlorohexidine

3.2b Povidone-Iodine

3.2c Iseganan

3.3 Prevention of maxillary sinusitis

Diagnoisis

4.0 Diagnosis: Invasive vs Non-invasive Techniques

Treatment

5.0 Initial Treatment of VAP

5.1 Empiric vs delayed culture directed therapy

5.2 Mono therapy vs combined empiric antibiotic therapy

6.0 Duration of Treatment of VAP

6.1 Duration of antibiotic use

6.2 Antibiotic discontinuation strategy based on clinical criteria

7.0 Choice of Antibiotic

7.1 Antibiotic "A" vs "B"

8.0 Administration of Antibiotics via Endotracheal Tube

8.1 Nebulized tobramycin via endotracheal tube

8.2 Instillation of tobramycin via endotracheal tube