Our Mission

As our aging population grows, so does the prevalence of respiratory-related ailments. To meet this medical need, a variety of new respiratory diagnostic and treatment options are being developed. With the availability of these new options, respiratory care professionals will require the most up-to-date, scientifically- and clinically-based information to help them make informed decisions on what is best for their patients.

Clinical Foundations provides practical, clinically- and evidenced-based articles, case studies and symposia for respiratory therapists and respiratory care directors, managers, and supervisors. Clinical Foundations is based on a patient-focused model of care that emphasizes the need to provide the care and services that focus on patients’ individual needs and preferences.

As part of our commitment to helping respiratory care professionals improve their skills, each edition of Clinical Foundations is fully accredited by the AARC for CRCEs.

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Clinical Foundations is published quarterly by Saxe Healthcare Communications.

Please direct your correspondence to:

Saxe Healthcare Communications

P.O. Box 1282

Burlington, VT 05402

sshapiro@saxecommunications.com

Fax: (802) 872-7558

CDC Recommendations on Preventing VAP

Sara Hanif Mirza, MD, MS and Carl A. Kaplan, MD

Mechanical ventilation is required in up to 50% of all critically ill patients during their hospital course. Ventilator-associated pneumonia (VAP) is not uncommon and is known to be associated with increased morbidity, mortality and length of stay. Currently, there is a renewed focus on VAP due to the financial reimbursement with a pay for performance fee structure. The pathogenesis of VAP is hypothesized to be due to the introduction of bacteria into the sterile lower respiratory tract. This article addresses the CDC recommendations for the known modifiable risk factors for VAP, back rest elevation, maintaining endotracheal tube cuff pressure, selection of endotracheal tube and placement, ventilator circuit care, de-contamination of oral flora, and minimizing sedation in the mechanically ventilated patient.

Panel Discussion: Preventing Ventilator-Associated Pneumonia (VAP)

Moderator: Marin Kollef, MD

Panelists: Teresa Volsko, MHHS, RRT, FAARC, Robert Joyner, PhD, RRT, Mark Konkle, MPA, RRT

In this panel discussion, 4 experts convene to discuss topics related to ventilator-associated pneumonia (VAP). Topics include (1) the importance of preventing disruptions in the ventilator circuit in order to prevent ventilator-associated infections such as VAP, iatrogenic viral infections including influenza, and aspiration events; (2) the need for VAP prevention protocols in all ICU’s caring for mechanically ventilated patients; (3) the role of cost-effectiveness of novel technologies, including specialized endotracheal tubes for ICU prevention programs; (4) means to minimize exposure to mechanical ventilation as a preventive measure against complications such as VAP; (5) whether VAP should be regarded as a quality indicator of ICU care, and (6) how to employ The Centers for Disease Control and Prevention new criteria for evaluating the quality of care provided in the intensive care setting, ventilator-associated conditions (VACs) and infection-related ventilator-associated conditions (IVACs).