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Respiratory - VAP

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Executive Summary: Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society.
Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O'Grady NP, Bartlett JG, Carratalà J, El Solh AA, Ewig S, Fey PD, File TM Jr, Restrepo MI, Roberts JA, Waterer GW, Cruse P, Knight SL, Brozek JL.
Clin Infect Dis. 2016 Sep 1;63(5):575-82.

Rationale for inclusion: IDSA guidelines for management of pneumonia. 

Citations - 200 (as of July 2017)

Short- vs long-duration antibiotic regimens for ventilator-associated pneumonia: a systematic review and meta-analysis.
Dimopoulos G, Poulakou G, Pneumatikos IA, Armaganidis A, Kollef MH, Matthaiou DK.
Chest. 2013 Dec;144(6):1759-67.

Rationale for inclusion: Meta analysis for the duration of antibiotics in VAP (more antibiotics free days, less relapse, no difference in mortality).

Citations - 63 (as of July 2017)

Economic impact of ventilator-associated pneumonia in a large matched cohort.
Kollef MH, Hamilton CW, Ernst FR.
Infect Control Hosp Epidemiol. 2012 Mar;33(3):250-6.

Rationale for inclusion: Well done description of the cost of VAP to the hospital admission.

Citations - 169 (as of July 2017)

Reducing ventilator-associated pneumonia in intensive care: impact of implementing a care bundle.
Morris AC, Hay AW, Swann DG, Everingham K, McCulloch C, McNulty J, Brooks O, Laurenson IF, Cook B, Walsh TS.
Crit Care Med. 2011 Oct;39(10):2218-24.

Rationale for inclusion: VAP Bundle in the ICU.

Citations - 176 (as of July 2017)

Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial.
Kollef MH, Afessa B, Anzueto A, Veremakis C, Kerr KM, Margolis BD, Craven DE, Roberts PR, Arroliga AC, Hubmayr RD, Restrepo MI, Auger WR, Schinner R; NASCENT Investigation Group.
JAMA. 2008 Aug 20;300(7):805-13.

Rationale for inclusion: Silver coated ET tubes reduce risk of pneumonia.

Citations - 470 (as of July 2017)

Randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia.
Heyland DK, Dodek P, Muscedere J, Day A, Cook D; Canadian Critical Care Trials Group.
Crit Care Med. 2008 Mar;36(3):737-44.

Rationale for inclusion: Adequacy of monotherapy in VAP with low risk of difficult to treat gram negative infection. 

Citations - 193 (as of July 2017)

Impact of inappropriate antibiotic therapy on mortality in patients with ventilator-associated pneumonia and blood stream infection: a meta-analysis.
Kuti EL, Patel AA, Coleman CI.
J Crit Care. 2008 Mar;23(1):91-100.

Rationale for inclusion: Meta-analysis of the impact of inappropriate initial antibiotics on mortality.

Citations - 110 (as of July 2017)

Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia.
Koeman M, van der Ven AJ, Hak E, Joore HC, Kaasjager K, de Smet AG, Ramsay G, Dormans TP, Aarts LP, de Bel EE, Hustinx WN, van der Tweel I, Hoepelman AM, Bonten MJ.
Am J Respir Crit Care Med. 2006 Jun 15;173(12):1348-55.

Rationale for inclusion: Chlorhexidine oral decontamination to reduce VAP.

Citations - 465 (as of July 2017)

Candida colonization of the respiratory tract and subsequent pseudomonas ventilator-associated pneumonia.
Azoulay E, Timsit JF, Tafflet M, de Lassence A, Darmon M, Zahar JR, Adrie C, Garrouste-Orgeas M, Cohen Y, Mourvillier B, Schlemmer B; Outcomerea Study Group.
Chest. 2006 Jan;129(1):110-7.

Rationale for inclusion: Colonization of airway with candida in mechanical ventilation more than 2 days and associated morbidities. 

Citations - 197 (as of July 2017)

Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia.
Resar R, Pronovost P, Haraden C, Simmonds T, Rainey T, Nolan T.
Jt Comm J Qual Patient Saf. 2005 May;31(5):243-8.

Rationale for inclusion: The Joint Commission bundle for VAP prevention.

Citations - 690 (as of July 2017)

Invasive approaches to the diagnosis of ventilator-associated pneumonia: a meta-analysis.
Shorr AF, Sherner JH, Jackson WL, Kollef MH.
Crit Care Med. 2005 Jan;33(1):46-53.

Rationale for inclusion: Meta-analysis of the invasive methods to diagnose VAP - no effect on mortality, but change in antibiotics choice. 

Citations - 190 (as of July 2017)

Value of the clinical pulmonary infection score for the identification and management of ventilator-associated pneumonia.
Luyt CE, Chastre J, Fagon JY.
Intensive Care Med. 2004 May;30(5):844-52.

Rationale for inclusion: CPIS should be followed by bronchoscopy for the diagnosis of VAP.

Citations - 188 (as of July 2017)

Clinical pulmonary infection score for ventilator-associated pneumonia: accuracy and inter-observer variability.
Schurink CA, Van Nieuwenhoven CA, Jacobs JA, Rozenberg-Arska M, Joore HC, Buskens E, Hoepelman AI, Bonten MJ.
Intensive Care Med. 2004 Feb;30(2):217-24.

Rationale for inclusion: CPIS has low sens and spec and high inter-rater variability for dx of VAP.

Citations - 180 (as of July 2017)

Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.
Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F, Wermert D, Clementi E, Gonzalez J, Jusserand D, Asfar P, Perrin D, Fieux F, Aubas S; PneumA Trial Group.
JAMA. 2003 Nov 19;290(19):2588-98.

Rationale for inclusion: 1 week vs 2 weeks of Abx for VAP.

Citations - 1136 (as of July 2017)

Resolution of ventilator-associated pneumonia: prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome.
Luna CM, Blanzaco D, Niederman MS, Matarucco W, Baredes NC, Desmery P, Palizas F, Menga G, Rios F, Apezteguia C.
Crit Care Med. 2003 Mar;31(3):676-82.

Rationale for inclusion: CPIS to follow resolution of pneumonia.

Citations - 580 (as of July 2017)

Rotation and restricted use of antibiotics in a medical intensive care unit. Impact on the incidence of ventilator-associated pneumonia caused by antibiotic-resistant gram-negative bacteria.
Gruson D, Hilbert G, Vargas F, Valentino R, Bebear C, Allery A, Bebear C, Gbikpi-Benissan G, Cardinaud JP.
Am J Respir Crit Care Med. 2000 Sep;162(3 Pt 1):837-43.

Rationale for inclusion: This paper introduces the concept of rotating empiric Abx for the Rx of VAP.

Citations - 382 (as of July 2017)

Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia.
Luna CM, Vujacich P, Niederman MS, Vay C, Gherardi C, Matera J, Jolly EC.
Chest. 1997 Mar;111(3):676-85.

Rationale for inclusion: Guiding study for use of BAL in diagnosis of VAP.

Citations - 1120 (as of July 2017)

Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia.
Vallés J, Artigas A, Rello J, Bonsoms N, Fontanals D, Blanch L, Fernández R, Baigorri F, Mestre J.
Ann Intern Med. 1995 Feb 1;122(3):179-86.

Rationale for inclusion: Study introducing the concept of subglottic suction port on ET tubes.

Citations - 675 (as of July 2017)

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