【医脉通指南频道】2014+SHEA／IDSA实践建议：急重症医院呼吸机相关性肺炎的预防策略（更新版）.pdf

infection control and hospital epidemiology august 2014, vol. 35, no. 8 s h e a / i d s a p r a c t i c e r e c o m m e n d a t i o n Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update Michael Klompas, MD, MPH;1,2 Richard Branson, MSc, RRT;3 Eric C. Eichenwald, MD;4 Linda R. Greene, RN, MPS, CIC;5 Michael D. Howell, MD, MPH;6 Grace Lee, MD;1,7 Shelley S. Magill, MD, PhD;8 Lisa L. Maragakis, MD, MPH;9 Gregory P. Priebe, MD;2,7,10 Kathleen Speck, MPH;11 Deborah S. Yokoe, MD, MPH;2 Sean M. Berenholtz, MD, MHS11,12,13 purpose surveillance definitions are subjective and nonspecific. Historically, 10%–20% of ventilated patients have de- Previously published guidelines are available that provide veloped VAP. More recent reports suggest much lower comprehensive recommendations for detecting and prevent- rates, but it is unclear to what extent these lower rates ing healthcare-associated infections (HAIs). The intent of this reflect better care versus stricter application of subjec- document is to highlight practical recommendations in a con- tive surveillance criteria.3,4 Notwithstanding surveil- cise format to assist acute care hospitals in implementing and lance rates that hover near zero, clinical surveys suggest prioritizing strategies to prevent ventilator-associated