Impact of a VAP bundle in Belgian intensive care units

[en] Background: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011–2012. This report will document the impact of this campaign. Methods: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients. For each of these, data about the application of the bundle and the possible treatment for VAP were recorded. Results: Between 36.6 and 54.8% of the 120 Belgian ICUs participated in the successive surveys. While the characteristics of ventilated patients remained similar throughout the years, the percentage of ventilated patients and especially the duration of ventilation significantly decreased before and after the national VAP bundle campaign. Ventilator care also profoundly changed: Controlling cuff pressure, head positioning above 30° were obtained in more than 90% of cases. Oral care was more frequently performed within a day, using more concentrated solutions of chlorhexidine. Subglottic suctioning also was used but in only 24.7% of the cases in the last years. Regarding the prevalence of VAP, it significantly decreased from 28% of ventilated patients in 2010 to 10.1% in 2016 (p ≤ 0.0001). Conclusion: Although a causal relationship cannot be inferred from these data, the successive surveys revealed a potential impact of the VAP bundle campaign on both the respiratory care of ventilated patients and the prevalence of VAP in Belgian ICUs encouraging them to follow the guidelines. © 2018, The Author(s).

Disciplines :

Anesthesia & intensive care

Author, co-author :

Jadot, L.; Service de Soins Intensifs Généraux, Domaine Universitaire du Sart-Tilman, Centre Hospitalier Universitaire, Liège, Belgium

Huyghens, L.; Dienst Intensieve Zorgen, VUB – Universitair Ziekenhuis Brussel, Campus Jette Laarbeeklaan 101, Brussels, Belgium

De Jaeger, A.; Pediatrische Intensieve Zorgen, Universitair Ziekenhuis Gent, De Pintelaan 185, Ghent, Belgium

Bourgeois, M.

Biarent, D.; Service Soins Intensifs et Urgences, Hôpital Universitaire des Enfants Reine Fabiola, Avenue Crocq 15, Brussels, Belgium

Higuet, A.; Urgentiegeneeskunde, Algemeen Ziekenhuis Sint-Maria, Ziekenhuislaan 100, Halle, Belgium

de Decker, K.; Intensieve Zorgen, Universitair Ziekenhuis Onze Lieve Vrouw, Moorselbaan 164, Aalst, Belgium

Vander Laenen, M.; Anesthesiologie – Kritieke Diensten, Ziekenhuis Oost-Limburg, Campus Sint-Jan, Schiepse Bos 6, Genk, Belgium

Oosterlynck, B.; Dienst Intensieve Zorgen, Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Ruddershove 10, Brugge, Belgium

Ferdinande, P.; Intensieve Zorgen, Universitair Ziekenhuis Leuven, Herestraat 49, Louvain, Belgium

More authors (6 more)

Language :

English

Title :

Impact of a VAP bundle in Belgian intensive care units

Publication date :

2018

Journal title :

Annals of Intensive Care

eISSN :

2110-5820

Publisher :

Springer Verlag

Volume :

Issue :

Pages :

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 16 January 2019

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