Skip to main content

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
Cancel
×
Home
Article
    • Aa
    • Aa
  • Cited by 8
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Schreiber, Matthew P and Shorr, Andrew F 2017. Challenges and opportunities in the treatment of ventilator-associated pneumonia. Expert Review of Anti-infective Therapy, Vol. 15, Issue. 1, p. 23.

    Blakeman, Thomas Rodriquez, Dario Woods, James Cox, Daniel Elterman, Joel and Branson, Richard 2016. Automated control of endotracheal tube cuff pressure during simulated flight. Journal of Trauma and Acute Care Surgery, Vol. 81, p. S116.

    Camus, Christophe Sauvadet, Elise Tavenard, Aude Piau, Caroline Uhel, Fabrice Bouju, Pierre Letheulle, Julien Dollo, Gilles Gacouin, Arnaud Lavoué, Sylvain and Le Tulzo, Yves 2016. Decline of multidrug-resistant Gram negative infections with the routine use of a multiple decontamination regimen in ICU. Journal of Infection, Vol. 73, Issue. 3, p. 200.

    Clemons, Julia and Kearns, Mark 2016. Invasive Mechanical Ventilation. Hospital Medicine Clinics, Vol. 5, Issue. 1, p. 17.

    Comeau, Nicholas P. 2016. Recognition, management, and prevention of burn sepsis in pediatric patients. Nursing Critical Care, Vol. 11, Issue. 6, p. 24.

    Jaillette, E. Ledoux, G. Lawson, R. Misset, B. and Nseir, S. 2016. Pneumonie acquise sous ventilation mécanique : quoi de neuf en 2016 ?. Réanimation, Vol. 25, Issue. S2, p. 83.

    Kalil, Andre C. Metersky, Mark L. Klompas, Michael Muscedere, John Sweeney, Daniel A. Palmer, Lucy B. Napolitano, Lena M. O'Grady, Naomi P. Bartlett, John G. Carratalà, Jordi El Solh, Ali A. Ewig, Santiago Fey, Paul D. File, Thomas M. Restrepo, Marcos I. Roberts, Jason A. Waterer, Grant W. Cruse, Peggy Knight, Shandra L. and Brozek, Jan L. 2016. 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. Clinical Infectious Diseases, Vol. 63, Issue. 5, p. e61.

    Kampf, G. 2016. Acquired resistance to chlorhexidine – is it time to establish an ‘antiseptic stewardship’ initiative?. Journal of Hospital Infection, Vol. 94, Issue. 3, p. 213.

    ×
  • Access

Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update

  • Michael Klompas (a1) (a2), Richard Branson (a3), Eric C. Eichenwald (a4), Linda R. Greene (a5), Michael D. Howell (a6), Grace Lee (a1) (a7), Shelley S. Magill (a8), Lisa L. Maragakis (a9), Gregory P. Priebe (a2) (a7) (a10), Kathleen Speck (a11), Deborah S. Yokoe (a2) and Sean M. Berenholtz (a11) (a12) (a13)...
Abstract

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format to assist acute care hospitals in implementing and prioritizing strategies to prevent ventilator-associated pneumonia (VAP) and other ventilator-associated events (VAEs) and to improve outcomes for mechanically ventilated adults, children, and neonates. This document updates “Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

    •
      • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update
      Available formats
      ×
Copyright
COPYRIGHT: © The Society for Healthcare Epidemiology of America 2014
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. DS Yokoe , DJ Andersen , SM Berenholtz , et al. Introduction to “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates.” Infect Control Hosp Epidemiol 2014;35(5):455–459.
3. MA Dudeck , TC Horan , KD Peterson , et al. National Healthcare Safety Network (NHSN) report, data summary for 2010, device-associated module. Am J Infect Control 2011;39(10): 798–816.
4. M. Klompas Eight initiatives that misleadingly lower ventilator-associated pneumonia rates. Am J Infect Control 2012;40(5): 408–410.
5. JL Vincent , J Relio , J Marshall , et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009;302(21):2323–2329.
6. SS Magill , W Hellinger , J Cohen , et al. Prevalence of healthcare-associated infections in acute care hospitals in Jacksonville, Florida. Infect Control Hosp Epidemiol 2012;33(3):283–291.
8. LP Skrupky , K McConnell , J Dallas , MH Kollef . A comparison of ventilator-associated pneumonia rates as identified according to the National Healthcare Safety Network and American College of Chest Physicians criteria. Crit Care Med 2012;40(1): 281–284.
10. M Klompas , Y Khan , K Kleinman , et al. Multicenter evaluation of a novel surveillance paradigm for complications of mechanical ventilation. PLoS ONE 2011;6(3):el8062.
11. M Klompas , S Magill , A Robicsek , et al. Objective surveillance definitions for ventilator-associated pneumonia. Crit Care Med 2012;40(12):3154–3161.
12. Y Hayashi , K Morisawa , M Klompas , et al. Toward improved surveillance: the impact of ventilator-associated complications on length of stay and antibiotic use in patients in intensive care units. Clin Infect Dis 2013;56(4):471–477.
13. E Prospero , D Illuminati , A Marigliano , et al. Learning from Galileo: ventilator-associated pneumonia surveillance. Am J Respir Crit Care Med 2012;186(12):1308–1309.
14. J Muscedere , T Sinuff , D Heyland , et al. The clinical impact and preventability of ventilator-associated conditions in critically ill mechanically ventilated patients. Chest 2013;144(5): 1453–1460.
15. PM Klein Klouwenberg , MS van Mourik , DS Ong , et al. Electronic implementation of a novel surveillance paradigm for ventilator-associated events: feasibility and validation. Am J Respir Crit Care Med 2014;189(8):947–955.
16. M Klompas , K Kleinman , MV Murphy . Descriptive epidemiology and attributable morbidity of ventilator-associated events. Infect Control Hosp Epidemiol 2014;35(5):502–510.
17. M Nguile-Makao , JR Zahar , A Francais , et al. Attributable mortality of ventilator-associated pneumonia: respective impact of main characteristics at ICU admission and VAP onset using conditional logistic regression and multi-state models. Intensive Care Med 2010;36(5):781–789.
18. M Bekaert , JF Timsit , S Vansteelandt , et al. Attributable mortality of ventilator associated pneumonia: a reappraisal using causal analysis. Am J Respir Crit Care Med 2011;184(10):1133–1139.
19. WG Melsen , MM Rovers , M Koeman , MJ Bonten . Estimating the attributable mortality of ventilator-associated pneumonia from randomized prevention studies. Crit Care Med 2011; 39(12):2736–2742.
20. WG Melsen , MM Rovers , RH Groenwold , et al. Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomised prevention studies. Lancet Infect Dis 2013;13(8):665–671.
21. N Safdar , C Dezfulian , HR Collard , S. Saint Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med 2005;33(10):2184–2193.
22. SH Kirtland , DE Corley , RH Winterbauer , et al. The diagnosis of ventilator-associated pneumonia: a comparison of histologic, microbiologic, and clinical criteria. Chest 1997;112(2):445–457.
23. M. Klompas Does this patient have ventilator-associated pneumonia? JAMA 2007;297(14):1583–1593.
24. RG Wunderink , LS Woldenberg , J Zeiss , CM Day , J Ciemins , DA Lacher . The radiologist diagnosis of autopsy-proven ventilator-associated pneumonia. Chest 1992;101(2):458–463.
25. E Tejerina , A Esteban , P Fernandez-Segoviano , et al. Accuracy of clinical definitions of ventilator-associated pneumonia: comparison with autopsy findings. J Crit Care 2010;25(l):62–68.
26. CA Schurink , CA van Nieuwenhoven , JA Jacobs , et al. Clinical pulmonary infection score for ventilator-associated pneumonia: accuracy and inter-observer variability. Intensive Care Med 2004;30(2):217–224.
27. M. Klompas Interobserver variability in ventilator-associated pneumonia surveillance. Am J Infect Control 2010;38(3):237–239.
28. PM Klein Klouwenberg , DS Ong , LD Bos , et al. Interobserver agreement of Centers for Disease Control and Prevention criteria for classifying infections in critically ill patients. Crit Care Med 2013;41(10):2373–2378.
29. JP Stevens , B Kachniarz , SB Wright , et al. When policy gets it right: variability in U.S. hospitals’ diagnosis of ventilator-associated pneumonia. Crit Care Med 2014;42(3):497–503.
30. ER Sherman , KH Heydon , KH St. John , et al. Administrative data fail to accurately identify cases of healthcare-associated infection. Infect Control Hosp Epidemiol 2006;27(4):332–337.
31. KB Stevenson , Y Khan , J Dickman , et al. Administrative coding data, compared with CDC/NHSN criteria, are poor indicators of health care-associated infections. Am J Infect Control 2008; 36(3):155–164.
132. M Drees , S Hausman , A Rogers , L Freeman , K Frosch , K. Wroten . Underestimating the impact of ventilator-associated pneumonia by use of surveillance data. Infect Control Hosp Epidemiol 2010;31(6):650–652.
33. M. Klompas The paradox of ventilator-associated pneumonia prevention measures. Crit Care 2009;13(5):315.
34. MJ Bonten . Ventilator-associated pneumonia: preventing the inevitable. Clin Infect Dis 2011;52(1):115–121.
35. M Klompas , R. Platt Ventilator-associated pneumonia—the wrong quality measure for benchmarking. Ann Intern Med 2007;147(ll):803–805.
36. HK van Saene , L Silvestri , MA de la Cal , P. Baines The emperor’s new clothes: the fairy tale continues. J Crit Care 2009; 24(1):149–152.
37. I Uckay , QA Ahmed , H Sax , D. Pittet Ventilator-associated pneumonia as a quality indicator for patient safety? Clin Infect Dis 2008;46(4):557–563.
38. S Blot , T Lisboa , R Angles , J. Relio Prevention of VAP: is zero rate possible? Clin Chest Med 2011;32(3):591–599.
39. SS Magill , M Klompas , R Balk , et al. Developing a new, national approach to surveillance for ventilator-associated events. Crit Care Med 2013;41(ll):2467–2475.
40. M Klompas , K Kleinman , R. Platt Development of an algorithm for surveillance of ventilator-associated pneumonia with electronic data and comparison of algorithm results with clinician diagnoses. Infect Control Hosp Epidemiol 2008;29(l):31–37.
41. M Klompas , K Kleinman , Y Khan , et al. Rapid and reproducible surveillance for ventilator-associated pneumonia. Clin Infect Dis 2012;54:370–377.
44. M. Klompas Ventilator-associated events surveillance: a patient safety opportunity. Curr Opin Crit Care 2013;19(5):424–431.
45. SC Lewis , L Li , MV Murphy , M. Klompas Risk factors for ventilator-associated events: a case-control multivariable analysis. Crit Care Med. doi:10.1097/CCM.0000000000000338. Electronically published April 18, 2014.
46. T Strom , T Martinussen , P. Toft A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 2010;375(9713):475–480.
47. EW Ely , AM Baker , DP Dunagan , et al. Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 1996;335(25):1864–1869.
48. TD Girard , JP Kress , BD Fuchs , et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 2008;371(9607):126–134.
49. WD Schweickert , MC Pohlman , AS Pohlman , et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 2009; 373(9678):1874–1882.
50. J Muscedere , O Rewa , K. McKechnie , X Jiang , D Laporta , DK Heyland . Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis. Crit Care Med 2011;39(8):1985–1991.
51. RM Determann , A Royakkers , EK Wolthuis , et al. Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care 2010;14(1):R1.
52. E Futier , J-M Constantin , C Paugam-Burtz , et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med 2013;369(5):428–437.
54. PC Hebert , G Wells , MA Blajchman , et al; Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999;340(6):409–417.
55. M. Klompas Prevention of ventilator-associated pneumonia. Expert Rev Anti Infect Ther 2010;8(7):791–800.
56. L Bouadma , M Wolff , JC Lucet . Ventilator-associated pneumonia and its prevention. Curr Opin Infect Dis 2012;25(4): 395–404.
59. M Carron , U Freo , AS BaHammam , et al. Complications of non-invasive ventilation techniques: a comprehensive qualitative review of randomized trials. Br J Anaesth 2013;110(6): 896–914.
61. J Barr , GL Fraser , K Puntillo , et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 2013;41(1): 263–306.
62. JP Kress , AS Pohlman , MF O’Connor , JB Hall . Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000;342(20):1471–1477.
63. WD Schweickert , BK Gehlbach , AS Pohlman , JB Hall , JP Kress . Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients. Crit Care Med 2004;32(6):1272–1276.
64. S Mehta , L Burry , D Cook , et al. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol. JAMA 2012:308(19):1985–1992.
65. JP Kress , JB Hall . The changing landscape of ICU sedation. JAMA 2012;308(19):2030–2031.
66. MH Kollef , SD Shapiro , P Silver , et al. A randomized, controlled trial of protocol-directed versus physician-directed weaning from mechanical ventilation. Crit Care Med 1997;25(4):567–574.
67. GP Marelich , S Murin , F Battistella , J Inciardi , T Vierra , M. Roby Protocol weaning of mechanical ventilation in medical and surgical patients by respiratory care practitioners and nurses: effect on weaning time and incidence of ventilator-associated pneumonia. Chest 2000;118(2):459–467.
68. F Lellouche , J Mancebo , P Joliiet , et al. A multicenter randomized trial of computer-driven protocolized weaning from mechanical ventilation. Am J Respir Crit Care Med 2006;174(8): 894–900.
69. A Esteban , F Frutos , MJ Tobin , et al; Spanish Lung Failure Collaborative Group. A comparison of four methods of weaning patients from mechanical ventilation. N Engl J Med 1995; 332(6):345–350.
70. RO Hopkins , VJ Spuhler , GE Thomsen . Transforming ICU culture to facilitate early mobility. Crit Care Clin 2007;23(1): 81–96.
71. PE Morris , A Goad , C Thompson , et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med 2008;36(8):2238–2243.
72. P Bailey , GE Thomsen , VJ Spuhler , et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med 2007; 35(1):139–145.
73. PE Morris , L Griffin , M Berry , et al. Receiving early mobility during an intensive care unit admission is a predictor of improved outcomes in acute respiratory failure. Am J Med Sci 2011;341(5):373–377.
74. C Burtin , B Clerckx , C. Robbeets , et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med 2009;37(9):2499–2505.
75. DM Needham , R Korupolu , JM Zanni , et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Rhys Med Rehabil 2010;91(4):536–542.
76. WL Titsworth , J Hester , T Correia , et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg 2012;116(6):1379–1388.
77. MC Balas , EE. Vasilevskis , KM Olsen , et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med 2014;42(5):1024–1036.
78. RK Lord , CR Mayhew , R Korupolu , et al. ICU early physical rehabilitation programs: financial modeling of cost savings. Crit Care Med 2013;41(3):717–724.
79. E Bouza , MJ Perez , P Munoz , C. Rincon , JM Barrio , J. Hortal Continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in the postoperative period of major heart surgery. Chest 2008;134(5):938–946.
80. JC Lacherade , B De Jonghe , P Guezennec , et al. Intermittent subglottic secretion drainage and ventilator-associated pneumonia: a multicenter trial. Am J Respir Crit Care Med 2010; 182(7):910–917.
81. AF Shorr , PG O’Malley . Continuous subglottic suctioning for the prevention of ventilator-associated pneumonia: potential economic implications. Chest 2001;119(l):228–235.
82. C. Hallais , V Merle , PG Guitard , et al. Is continuous subglottic suctioning cost-effective for the prevention of ventilator-associated pneumonia? Infect Control Hosp Epidemiol 2011; 32(2):131–135.
83. SA Frost , A Azeem , E Alexandrou , et al. Subglottic secretion drainage for preventing ventilator associated pneumonia: a meta-analysis. Aust Crit Care 2013;26(4):180–188.
84. MB Drakulovic , A Torres , TT Bauer , JM Nicolas , S Nogue , M. Ferrer Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial. Lancet 1999;354(9193):1851–1858.
85. CA van Nieuwenhoven , C. Vandenbroucke-Grauls , FH van Tiel , et al. Feasibility and effects of the semirecumbent position to prevent ventilator-associated pneumonia: a randomized study. Crit Care Med 2006;34(2):396–402.
86. L. Keeley Reducing the risk of ventilator-acquired pneumonia through head of bed elevation. Nurs Crit Care 2007;12(6):287–294.
87. VG Alexiou , V Ierodiakonou , G Dimopoulos , ME Falagas . Impact of patient position on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials, J Crit Care 2009;24(4):515–522.
88. D Dreyfuss , K Djedaini , P Weber , et al. Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change. Am Rev Respir Dis 1991;143(4 pt 1): 738–743.
89. MH Kollef , SD Shapiro , VJ Fraser , et al. Mechanical ventilation with or without 7-day circuit changes: a randomized controlled trial. Ann Intern Med 1995;123(3):168–174.
90. MN Long , G Wickstrom , A Grimes , CF Benton , B Belcher , AM Stamm . Prospective, randomized study of ventilator-associated pneumonia in patients with one versus three ventilator circuit changes per week. Infect Control Hosp Epidemiol 1996;17(1):14–19.
91. L Lorente , M Lecuona , R Galvan , MJ Ramos , ML Mora , A. Sierra Periodically changing ventilator circuits is not necessary to prevent ventilator-associated pneumonia when a heat and moisture exchanger is used. Infect Control Hosp Epidemiol 2004; 25(12):1077–1082.
94. E de Jonge , MJ Schultz , L Spanjaard , et al. Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet 2003;362(9389):1011–1016.
95. AM de Smet , JA Kluytmans , BS Cooper , et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 2009;360(l):20–31.
98. EY Chan , A Ruest , MO Meade , DJ Cook . Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis. BMJ 2007;334(7599):889.
99. N Daneman , S Sarwar , RA Fowler , BH Cuthbertson . Effect of selective decontamination on antimicrobial resistance in intensive care units: a systematic review and meta-analysis. Lancet Infect Dis 2013;13(4):328–341.
100. JW van der Meer , CM Vandenbroucke-Grauls . Resistance to selective decontamination: the jury is still out. Lancet Infect Dis 2013;13(4):282–283.
101. MP Chlebicki , N. Safdar Topical chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. Crit Care Med 2007;35(2):595–602.
102. C Pileggi , A Bianco , D Flotta , CG Nobile , M. Pavia Prevention of ventilator-associated pneumonia, mortality and all intensive care unit acquired infections by topically applied antimicrobial or antiseptic agents: a meta-analysis of randomized controlled trials in intensive care units. Crit Care 2011;15(3):R155.
103. SO Labeau , K Van de Vyver , N Brusselaers , D Vogelaers , SI Blot . Prevention of ventilator-associated pneumonia with oral antiseptics: a systematic review and meta-analysis. Lancet Infect Dis 2011;11(11):845–854.
104. H Tantipong , C Morkchareonpong , S Jaiyindee , V. Thamlikitkul Randomized controlled trial and meta-analysis of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia. Infect Control Hosp Epidemiol 2008;29(2):131–136.
105. J Li , D Xie , A Li , J. Yue Oral topical decontamination for preventing ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials. J Hosp Infect 2013;84(4):283–293.
108. M Klompas , K Speck , MD Howell , LR Greene , SM Berenholtz . Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis. JAMA Intern Med 2014;174(5):751–761.
109. AJ DeRiso 2nd, JS Ladowski , TA Dillon , JW Justice , AC Peterson . Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonpro-phylactic systemic antibiotic use in patients undergoing heart surgery. Chest 1996;109(6):1556–1561.
110. P Segers , RG Speekenbrink , DT Ubbink , ML van Ogtrop , BA de Mol . Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial. JAMA 2006;296(20):2460–2466.
111. II Siempos , TK Ntaidou , ME Falagas . Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials. Crit Care Med 2010;38(3):954–962.
112. KX Liu , YG Zhu , J Zhang , et al. Probiotics’ effects on the incidence of nosocomial pneumonia in critically ill patients: a systematic review and meta-analysis. Crit Care 2012;16(3): R109.
113. EO Petrof , R Dhaliwal , W Manzanares , J Johnstone , D Cook , DK Heyland . Probiotics in the critically ill: a systematic review of the randomized trial evidence. Crit Care Med 2012;40(12): 3290–3302.
114. D Barraud , PE Bollaert , S. Gibot Impact of the administration of probiotics on mortality in critically ill adult patients: a meta-analysis of randomized controlled trials. Chest 2013;143(3): 646–655.
115. T Lherm , C Monet , B Nougiere , et al. Seven cases of fungemia with Sacchawmyces boulardii in critically ill patients. Intensive Care Med 2002;28(6):797–801.
116. P Munoz , E Bouza , M Cuenca-Estrella , et al. Sacchawmyces cerevisiae fungemia: an emerging infectious disease. Clin Infect Dis 2005;40(11):1625–1634.
117. MK Salminen , H Rautelin , S Tynkkynen , et al. Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG. Clin Infect Dis 2004;38(l):62–69.
118. M Cassone , P Serra , F Mondello , et al. Outbreak of Sacchawmyces cerevisiae subtype boulardii fungemia in patients neighboring those treated with a probiotic preparation of the organism. J Clin Microbiol 2003;41(ll):5340–5343.
119. C Graf , G Gavazzi . Sacchawmyces cerevisiae fungemia in an immunocompromised patient not treated with Sacchawmyces boulardii preparation, J Infect 2007;54(3):310–311.
120. L Lorente , M Lecuona , A Jimenez , ML Mora , A. Sierra Influence of an endotracheal tube with polyurethane cuff and sub-glottic secretion drainage on pneumonia. Am J Respir Crit Care Med 2007;176(11):1079–1083.
121. J Poelaert , P Depuydt , A De Wolf , S Van de Velde , I Herek , S. Blot Polyurethane cuffed endotracheal tubes to prevent early postoperative pneumonia after cardiac surgery: a pilot study. J Thorac Cardiovasc Surg 2008;135(4):771–776.
122. M Valencia , M Ferrer , R Farre , et al. Automatic control of tracheal tube cuff pressure in ventilated patients in semi-recumbent position: a randomized trial. Crit Care Med 2007; 35(6):1543–1549.
123. S Nseir , F Zerimech , C Fournier , et al. Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients. Am J Respir Crit Care Med 2011;184(9): 1041–1047.
124. P Caruso , S Denari , SA Ruiz , SE Demarzo , D. Deheinzelin Saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia. Crit Care Med 2009;37(l):32–38.
125. LY Yao , CK Chang , SH Maa , C Wang , CC Chen . Brushing teeth with purified water to reduce ventilator-associated pneumonia. J Nurs Res 2011;19(4):289–297.
126. W Alhazzani , O Smith , J Muscedere , J Medd , D. Cook Tooth-brushing for critically ill mechanically ventilated patients: a systematic review and meta-analysis of randomized trials evaluating ventilator-associated pneumonia. Crit Care Med 2013; 41(2):646–655.
127. MH Kollef , A Afessa , A Anzueto , et al. Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial. JAMA 2008;300(7):805–813.
129. S Sud , M Sud , JO Friedrich , NK Adhikari . Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis. Can Med Assoc J 2008;178(9):1153–1161.
130. AH Alsaghir , CM Martin . Effect of prone positioning in patients with acute respiratory distress syndrome: a meta-analysis. Crit Care Med 2008;36(2):603–609.
131. F Abroug , L Ouanes-Besbes , S Elatrous , L. Brochard The effect of prone positioning in acute respiratory distress syndrome or acute lung injury: a meta-analysis. Areas of uncertainty and recommendations for research. Intensive Care Med 2008;34(6): 1002–1011.
132. P Kopterides , Siempos II, A. Armaganidis Prone positioning in hypoxemic respiratory failure: meta-analysis of randomized controlled trials. J Crit Care 2009;24(1):89–100.
133. F Abroug , L Ouanes-Besbes , F Dachraoui , I Ouanes , L. Brochard An updated study-level meta-analysis of randomised controlled trials on proning in ARDS and acute lung injury. Crit Care 2011;15(1):R6.
134. C Guerin , J Reignier , JC Richard , et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013; 368(23):2159–2168.
135. PE Marik , T Vasu , A Hirani , M. Pachinburavan Stress ulcer prophylaxis in the new millennium: a systematic review and meta-analysis. Crit Care Med 2010;38(ll):2222–2228.
136. W Alhazzani , F Alenezi , RZ Jaeschke , P Moayyedi , DJ Cook . Proton pump inhibitors versus histamine 2 receptor antagonists for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis. Crit Care Med 2013;41(3): 693–705.
137. F Wang , Y Wu , L Bo , et al. The timing of tracheotomy in critically ill patients undergoing mechanical ventilation: a systematic review and meta-analysis of randomized controlled trials. Chest 2011;140(6):1456–1465.
138. J Reignier , E Mercier , A Le Gouge , et al. Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: a randomized controlled trial. JAMA 2013; 309(3):249–256.
139. MP Casaer , D Mesotten , G Hermans , et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med 2011; 365(6):506–517.
140. RP Vonberg , T Eckmanns , T Weite , P. Gastmeier Impact of the suctioning system (open vs. closed) on the incidence of ventilation-associated pneumonia: meta-analysis of randomized controlled trials. Intensive Care Med 2006;32(9):1329–1335.
141. IP Jongerden , MM Rovers , MH Grypdonck , MJ Bonten . Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a meta-analysis. Crit Care Med 2007;35(l):260–270.
142. II Siempos , KZ Vardakas , ME Falagas . Closed tracheal suction systems for prevention of ventilator-associated pneumonia. Br J Anaesth 2008;100(3):299–306.
143. IP Jongerden , AG Buiting , MA Leverstein-vanHall , et al. Effect of open and closed endotracheal suctioning on cross-transmission with gram-negative bacteria: a prospective crossover study. Crit Care Med 2011;39(6):1313–1321.
144. L Lorente , M Lecuona , A Jimenez , ML Mora , A. Sierra tracheal suction by closed system without daily change versus open system. Intensive Care Med 2006;32(4):538–544.
145. SM Maggiore . Endotracheal suctioning, ventilator-associated pneumonia, and costs: open or closed issue? Intensive Care Med 2006;32(4):485–487.
147. V Bhandari , NN Finer , RA Ehrenkranz , et al. Synchronized nasal intermittent positive-pressure ventilation and neonatal outcomes. Pediatrics 2009;124(2):517–526.
149. V. Bhandari Nasal intermittent positive pressure ventilation in the newborn: review of literature and evidence-based guidelines. } Perinatol 2010;30(8):505–512.
152. A Veldman , T Trautschold , K Weiss , D Fischer , K. Bauer Characteristics and outcome of unplanned extubation in ventilated preterm and term newborns on a neonatal intensive care unit. Paediatr Anaesth 2006;16(9):968–973.
153. R Samransamruajkit , S Jirapaiboonsuk , S Siritantiwat , et al. Effect of frequency of ventilator circuit changes (3 vs 7 days) on the rate of ventilator-associated pneumonia in PICU. J Crit Care 2010;25(1):56–61.
154. TC Hsieh , SH Hsia , CT Wu , TY Lin , CC Chang , KS Wong . Frequency of ventilator-associated pneumonia with 3-day versus 7-day ventilator circuit changes. Pediatr Neonatol 2010; 51(l):37–43.
155. H Aly , M Badawy , A El-Kholy , R Nabil , A. Mohamed Randomized, controlled trial on tracheal colonization of ventilated infants: can gravity prevent ventilator-associated pneumonia? Pediatrics 2008;122(4):770–774.
157. MB van Veenendaal , M Miedema , FH de Jongh , JH van der Lee , I Frerichs , AH van Kaam . Effect of closed endotracheal suction in high-frequency ventilated premature infants measured with electrical impedance tomography. Intensive Care Med 2009;35(12):2130–2134.
158. G Terrin , A Passariello , M de Curtis , et al. Ranitidine is associated with infections, necrotizing enterocolitis, and fatal outcome in newborns. Pediatrics 2012;129(l):e40–e45.
159. R Guillet , BJ Stoll , CM Cotten , et al. Association of H2-blocker therapy and higher incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics 2006;117(2):el37–el42.
160. VS Kuppala , J Meinzen-Derr , AL Morrow , KR Schibier . Prolonged initial empirical antibiotic treatment is associated with adverse outcomes in premature infants, J Pediatr 2011;159(5): 720–725.
161. VN Alexander , V Northrup , MJ Bizzarro . Antibiotic exposure in the newborn intensive care unit and the risk of necrotizing enterocolitis. J Pediatr 2011;159(3):392–397.
162. P Shah , E Nathan , D Doherty , S. Patole Prolonged exposure to antibiotics and its associations in extremely preterm neo-nates—the western Australian experience. J Matern Fetal Neonatal Med 2013;26(17):1710–1714.
163. AS Weintraub , L Ferrara , L Deluca , et al. Antenatal antibiotic exposure in preterm infants with necrotizing enterocolitis, J Perinatol 2012;32(9):705–709.
165. J Kaczmarek , CO Kamiin , CJ Morley , PG Davis , GM Sant’anna . Variability of respiratory parameters and extubation readiness in ventilated neonates. Arch Dis Child Fetal Neonatal Ed 2013; 98(1):F70–F73.
167. MA Rojas , JM Lozano , MX Rojas , et al. Prophylactic probiotics to prevent death and nosocomial infection in preterm infants. Pediatrics 2012;130(5):elll3–ell20.
168. P Manzoni , M Mostert , ML Leonessa , et al. Oral supplementation with Lactobacillus casei subspecies rhamnosus prevents enteric colonization by Candida species in preterm neonates: a randomized study. Clin Infect Dis 2006; 42(12):1735–1742.
169. MA De Groote , DN Frank , E Dowell , MP Glode , NR Pace . Lactobacillus rhamnosus GG bacteremia associated with pro-biotic use in a child with short gut syndrome. Pediatr Infect Dis J 2005;24(3):278–280.
170. AN Kunz , JM Noel , MR Fairchok Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr 2004;38(4):457–458.
172. E Foglia , MD Meier , A. Elward Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients. Clin Microbiol Rev 2007;20(3):409–425.
173. MT Bigham , R Amato , P Bondurrant , et al. Ventilator-associated pneumonia in the pediatric intensive care unit: characterizing the problem and implementing a sustainable solution. J Pediatr 2009;154(4):582e2–587e2.
174. BR Taira , KE Fenton , TK Lee , et al. Ventilator-associated pneumonia in pediatric trauma patients. Pediatr Crit Care Med 2009; 10(4) :491–494.
176. S Awasthi , M Tahazzul , A Ambast , YC Govil , A. Jain Longer duration of mechanical ventilation was found to be associated with ventilator-associated pneumonia in children aged 1 month to 12 years in India, J Clin Epidemiol 2013;66(l):62–66.
177. WF Liljemark , C. Bloomquist Human oral microbial ecology and dental caries and periodontal diseases. Crit Rev Oral Biol Med 1996;7(2):180–198.
178. E. Kononen Development of oral bacterial flora in young children. Ann Med 2000;32(2):107–112.
179. E Javouhey , A Barats , N Richard , D Stamm , D. Floret Noninvasive ventilation as primary ventilatory support for infants with severe bronchiolitis. Intensive Care Med 2008;34(9):1608–1614.
180. LJ Yanez , M Yunge , M Emilfork , et al. A prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure. Pediatr Crit Care Med 2008;9(5):484–489.
181. LP Ferguson , BK Walsh , D Munhall , JH Arnold . A spontaneous breathing trial with pressure support overestimates readiness for extubation in children. Pediatr Crit Care Med 2011;12(6): e330–e335.
182. AG Randolph , D Wypij , ST Venkataraman , et al. Effect of mechanical ventilator weaning protocols on respiratory outcomes in infants and children: a randomized controlled trial. JAMA 2002;288(20):2561–2568.
183. FK Foronda , EJ Troster , JA Farias , et al. The impact of daily evaluation and spontaneous breathing test on the duration of pediatric mechanical ventilation: a randomized controlled trial. Crit Care Med 2011;39(ll):2526–2533.
184. CJ Newth , S Venkataraman , DF Willson , et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med 2009;10(l):l–ll.
185. PS Lucas da Silva , WB de Carvalho . Unplanned extubation in pediatric critically ill patients: a systematic review and best practice recommendations. Pediatr Crit Care Med 2010;11(2): 287–294.
186. MA Curley , E Schwalenstocker , JK Deshpande , et al. Tailoring the Institute for Health Care Improvement 100,000 Lives Campaign to pediatric settings: the example of ventilator-associated pneumonia. Pediatr Clin North Am 2006;53(6):1231–1251.
188. HH Tsai , FC Lin , SC Chang . Intermittent suction of oral secretions before each positional change may reduce ventilator-associated pneumonia: a pilot study. Am J Med Sci 2008;336(5): 397–401.
189. V Gopalareddy , Z He , S Soundar , et al. Assessment of the prevalence of microaspiration by gastric pepsin in the airway of ventilated children. Acta Paediatr 2008;97(l):55–60.
190. M Weiss , A Dullenkopf , JE Fischer , C Keller , AC Gerber . Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth 2009;103(6):867–873.
191. ME Kleinman , AR de Caen , L Chameides , et al. Part 10: pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation 2010;122(16 suppl 2):S466–S515.
192. K Gupta , VK Gupta , M Jayashree , S. Singhi Randomized controlled trial of interrupted versus continuous sedative infusions in ventilated children. Pediatr Crit Care Med 2012;13(2):131–135.
193. MR Sebastian , R Lodha , A Kapii , SK Kabra . Oral mucosal decontamination with chlorhexidine for the prevention of ventilator-associated pneumonia in children—a randomized, controlled trial. Pediatr Crit Care Med 2012;13(5):e305–e310.
195. AD Jacomo , F Carmona , AK Matsuno , PH Manso , AP Carlotti . Effect of oral hygiene with 0.12% chlorhexidine gluconate on the incidence of nosocomial pneumonia in children undergoing cardiac surgery. Infect Control Hosp Epidemiol 2011 ;32(6): 591–596.
196. DM Kusahara , LT Friedlander , MA Peterlini , ML Pedreira . Oral care and oropharyngeal and tracheal colonization by gram-negative pathogens in children. Nurs Crit Care 2012; 17(3):115–122.
197. DM Kusahara , MA Peterlini , ML Pedreira . Oral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: randomised, controlled and double blind trial. Int J Nurs Stud 2012;49(11):1354–1363.
198. ML Pedreira , DM Kusahara , WB de Carvalho , SC Nunez , MA Peterlini . Oral care interventions and oropharyngeal colonization in children receiving mechanical ventilation. Am J Crit Care 2009;18(4):319–328.
199. D Yildizdas , H Yapicioglu , HL Yilmaz . Occurrence of ventilator-associated pneumonia in mechanically ventilated pediatric intensive care patients during stress ulcer prophylaxis with sucralfate, ranitidine, and omeprazole. J Crit Care 2002;17(4): 240–245.
200. E Lopriore , DG Markhorst , RJ Gemke . Ventilator-associated pneumonia and upper airway colonisation with gram negative bacilli: the role of stress ulcer prophylaxis in children. Intensive Care Med 2002;28(6):763–767.
201. BM Morrow , R Mowzer , R Pitcher , AC Argent . Investigation into the effect of closed-system suctioning on the frequency of pediatric ventilator-associated pneumonia in a developing country. Pediatr Crit Care Med 2012;13(1):e25–e32.
203. PJ Pronovost , SM Berenholtz , DM Needham . Translating evidence into practice: a model for large scale knowledge translation. BMJ 2008;337:al714.
204. WS Krimsky , IB Mroz , JK Mcllwaine , et al. A model for increasing patient safety in the intensive care unit: increasing the implementation rates of proven safety measures. Qual Saf Health Care 2009;18(l):74–80.
205. CS Hawe , KS Ellis , CJ Cairns , A. Longmate Reduction of ventilator-associated pneumonia: active versus passive guideline implementation. Intensive Care Med 2009;35(7):1180–1186.
206. J Relio , H Lode , G Cornaglia , R. Masterton A European care bundle for prevention of ventilator-associated pneumonia. Intensive Care Med 2010;36(5):773–780.
207. SM Berenholtz , JC Pham , DA Thompson , et al. Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit. Infect Control Hosp Epidemiol 2011;32(4):305–314.
208. M. Klompas Ventilator-associated pneumonia: is zero possible? Clin Infect Dis 2010;51(10):1123–1126.
209. E Crunden , C Boyce , H Woodman , B. Bray An evaluation of the impact of the ventilator care bundle. Nurs Crit Care 2005; 10(5):242–246.
210. CD Burger , RK Resar . “Ventilator bundle” approach to prevention of ventilator-associated pneumonia. Mayo Clin Proc 2006;81(6):849–850.
211. A Apisarnthanarak , U Pinitchai , K Thongphubeth , et al. Effectiveness of an educational program to reduce ventilator-associated pneumonia in a tertiary care center in Thailand: a 4-year study. Clin Infect Dis 2007;45(6):704–711.
213. F Bloos , S Muller , A Harz , et al. Effects of staff training on the care of mechanically ventilated patients: a prospective cohort study. Br J Anaesth 2009;103(2):232–237.
214. T Sinuff , J Muscedere , DJ Cook , et al. Implementation of clinical practice guidelines for ventilator-associated pneumonia: a mul-ticenter prospective study. Crit Care Med 2013;41(l):15–23.
, , , et al. . ():– (in this issue).216. K Ellingson JP Haas AE Aiello Strategies to prevent healthcare-associated infections through hand hygiene Infect Control Hosp Epidemiol 35 8 937960
217. JM Boles , J Bion , A Connors , et al. Weaning from mechanical ventilation. Eur Respir J 2007;29(5):1033–1056.
218. D Aragon , ML Sole . Implementing best practice strategies to prevent infection in the ICU. Crit Care Nurs Clin North Am 2006;18(4):441–452.
219. SM Burns , S Earven , C Fisher , et al. Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: one-year outcomes and lessons learned. Crit Care Med 2003;31(12):2752–2763.
220. J Brierley , L Highe , S Hines , G. Dixon Reducing VAP by instituting a care bundle using improvement methodology in a UK paediatric intensive care unit. Eur J Pediatr 2012;171(2): 323–330.
221. LJ Weireter Jr, JN Collins , RC Britt , SF Reed , TJ Novosel , LD Britt . Impact of a monitored program of care on incidence of ventilator-associated pneumonia: results of a longterm performance-improvement project. J Am Coll Surg 2009;208(5):700–704.
223. J Heimes , C Braxton , N Nazir , et al. Implementation and enforcement of ventilator-associated pneumonia prevention strategies in trauma patients. Surg Infect (Larchmt) 2011;12(2): 99–103.
224. DE Craven . Preventing ventilator-associated pneumonia in adults: sowing seeds of change. Chest 2006; 130(1):251–260.
225. JE Mangino , P Peyrani , KD Ford , et al. Development and implementation of a performance improvement project in adult intensive care units: overview of the Improving Medicine Through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) study. Crit Care 2011; 15(1):R38.
226. DC Scales , K Dainty , B Hales , et al. A multifaceted intervention for quality improvement in a network of intensive care units: a cluster randomized trial. JAMA 2011;305(4):363–372.
227. J Relio , E Afonso , T Lisboa , et al. A care bundle approach for prevention of ventilator-associated pneumonia. Clin Microhiol infect 2013;19(4):363–369.
228. J Grimshaw , M Eccles , R Thomas , et al. Toward evidence-based quality improvement: evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966-1998. J Gen Intern Med 2006;21(suppl 2):S14–S20.
229. S Berenholtz , PJ Pronovost . Barriers to translating evidence into practice. Curr Opin Crit Care 2003;9(4):321–325.
230. L Bouadma , B Mourvillier , V Deiler , et al. Changes in knowledge, beliefs, and perceptions throughout a multifaceted behavioral program aimed at preventing ventilator-associated pneumonia. Intensive Care Med 2010;36(8):1341–1347.
231. GL Bassi , M Ferrer , LM Saucedo , A. Torres Do guidelines change outcomes in ventilator-associated pneumonia? Curr Opin Infect Dis 2010;23(2):171–177.
232. F. Lyerla Design and implementation of a nursing clinical decision support system to promote guideline adherence. Comput Inform Nurs 2008;26(4):227–233.
233. T Sinuff , J Muscedere , D Cook , P Dodek , D. Heyland Ventilator-associated pneumonia: improving outcomes through guideline implementation. J Crit Care 2008;23(1):118–125.
234. R Omrane , J Eid , MM Perreault , et al. Impact of a protocol for prevention of ventilator-associated pneumonia. Ann Phar-macother 2007;41(9):1390–1396.
235. V Zaydfudim , LA Dossett , JM Starmer , et al. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle. Arch Surg 2009;144(7):656–662.
236. N Salahuddin , A Zafar , L Sukhyani , et al. Reducing ventilator-associated pneumonia rates through a staff education programme. J Hosp Infect 2004;57(3):223–227.
237. S. Westwell Implementing a ventilator care bundle in an adult intensive care unit. Nurs Crit Care 2008;13(4):203–207.
238. A Pinto , S Burnett , J Benn , et al. Improving reliability of clinical care practices for ventilated patients in the context of a patient safety improvement initiative. J Eval Clin Pract 2011;17(1):180–187.
239. GH Guyatt , AD Oxman , GE Vist , et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924–926.
241. VD Rosenthal , ME Rodriguez-Calderon , M Rodriguez-Ferrer , et al. Findings of the International Nosocomial Infection Control Consortium (INICC), part II: impact of a multidimensional strategy to reduce ventilator-associated pneumonia in neonatal intensive care units in 10 developing countries. Infect Control Hosp Epidemiol 2012;33(7):704–710.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *

CAPTCHA *

Skip to the audio challenge
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 3179 *
Loading metrics...

Abstract views

Total abstract views: 4138 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd June 2017. This data will be updated every 24 hours.

Cancel
Confirm
×