the tracheal tube gateway to ventilator-associated pneumonia与机械通气相关肺炎的气管导管网关.pdfVIP

Zolfaghari and Wyncoll Critical Care 2011, 15:310 /content/15/5/310 V I E W P O I N T The tracheal tube: gateway to ventilator-associated pneumonia 1 2 Parjam S Zolfaghari * and Duncan LA Wyncoll 1990 showed the incidence of VAP to be 10 to 20%, with Abstract a possible two-fold increase in mortality attributable to Ventilator-associated pneumonia (VAP) is a major VAP [3]. h e ICU length of stay was also signifi cantly healthcare-associated complication with considerable increased by a mean of 6.1 days with an attributable cost attributable morbidity, mortality and cost. Inherent of $10,019 per case [3]. A recent Canadian study esti- design l aws in the standard high-volume low- mated an additional 4.3 ICU days attributable to VAP, pressure cuf ed tracheal tubes form a major part of the occupying 2% of all ICU days and an estimated national pathogenic mechanism causing VAP. The formation cost of CAN$43 million per year [4]. Similar fi ndings of folds in the inl ated cuf leads to microaspiration were reported by a North American study with increased of pooled oropharyngeal secretions into the trachea, unadjusted ICU length of stay and mortality in patients and bioi lm formation on the inner surface of the with VAP (50% mortality in VAP patients versus 34% in tracheal tube helps to maintain bacterial colonization non-VAP) with an estimated $11,897 attributable cost of the lower airways. Improved design of