Ventilator-Associated Pneumonia VAP

Health and Science For Sunday 102410

Hey folks,

Did you know it was just International Infection Prevention Week? It is the largest annual initiative to promote safe, hygienic hospital practices and stop Healthcare-Associated Infections (HAIs) before they happen.

Do you remember back on Sunday, May 30, 2010, I introduced you to Kimberly-Clark Health Care. I posted HAIs and Prevention
I said this.

Imagine going into the Hospital for, oh, I don't know, say Gallbladder Surgery, and all of a sudden, you have Staph or another sickness that you didn't have coming in. Some estimate that the cost for HAIs is somewhere in the Billions a year. So why is someone not doing something about it?

Well, there are. One such Organization is Kimberly-Clark.

We talked about Healthcare-Associated Infections, and the steps that Kimberly-Clark is taking to help prevent them. Well one of these is Ventilator-Associated Pneumonia (VAP).

According to their Website:

A subset of HAP, Ventilator-Associated Pneumonia (VAP) refers to those cases that occur in patients who have been on ventilator support for at least 48 hours. The mechanisms for HAP and VAP infections are similar, although due to the fact that host defenses against pneumonia are so effectively bypassed by an endotracheal tube, the risk of pneumonia in ventilated patients is much higher.

VAP Risk Factors

The single largest VAP risk factor is the endotracheal tube. Because mechanical ventilator support cannot be performed without the endotracheal tube (or other artificial airway), it is a necessary evil. The endotracheal tube provides a direct passageway into the lungs, bypassing many "natural protection" mechanisms. The endotracheal tube increases the risk for VAP by:

•preventing cough (the patients natural defense)
•preventing upper airway filtering
•preventing upper airway humidification
•inhibiting epiglottic and upper airway reflexes
•inhibiting cilliary transport by the epithelium
•acting as a direct conduit into the lungs for airborne pathogens
•potentially acting as a reservoir for pathogens by providing a place for biofilm to form
•having a cuff which provides a place for secretions to “pool” in the hypoglottic area
•initiating a foreign body reaction, interfering with the local immune response

Host or patient risk factors include:

•age of 65 or more
•underlying chronic illness (e.g. Chronic Obstructive Pulmonary Disease (COPD), emphysema, asthma)
•immunosuppression
•depressed consciousness
•thoracic or abdominal surgery
•previous antibiotic therapy
•previous pneumonia or remote infection

Other device treatment and personnel related risk factors include:

•nasogastric tube placement
•bolus enteral feeding
•gastric over-distension
•stress ulcer treatment
•supine patient position
•nasal intubation route
•instillation of normal saline
•understaffing
•nonconformance to handwashing protocol
•indiscriminate use of antibiotics
•lack of training in VAP prevention

You can go to their Website, especially if you are in the Medical Field, and I know there are some Doctors out there in OPNTalk Land, and join the New HAI WATCHDOG Community.

Join the community of healthcare professionals concerned with preventing Healthcare-Associated Infections (HAIs), which at any given moment seriously affect 1.4 million hospitalized patients worldwide. The HAI WATCHDOG* forums are intended to provide a place for
health care providers to discuss issues and best practices related to
Hospital-Associated Infections (HAIs).

Kimberly-Clark is committed to helping win the battle to prevent HAIs. As part of that effort, we are pleased to sponsor this new community
site for healthcare providers to discuss HAI without discussion of product-specific information.

As I said back then, I mean even more now, Kimberly-Clark is worth getting to know. For more information about Kimberly-Clark or the "Not On My Watch" campaign, or more information on VAP, go to their Website and check them out. It will be well worth your time.
Peter