Keywords
Patient Care Bundles
Pneumonia
Ventilator-Associated
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Abstract
Objective: To describe the main updates of the Ventilator-associated pneumonia (VAP) bundle, as well as to relate them to evidence found in the literature. Bibliographic review: The VAP bundle components include the following: maintain an elevated position (30-45°); adjust the level of sedation and the spontaneous breathing test on a daily basis; aspirate the subglottic secretion routinely; perform oral hygiene with antiseptics; judicious use of neuromuscular blockers; giving preference to using non-invasive mechanical ventilation; care with the ventilator circuit; indication and care with humidifiers; indication and care with the aspiration system; avoid unscheduled (accidental) extubation and reintubation; cuff pressure monitoring; give preference to orotracheal intubation; care with inhalers and nebulizers; enteral probe in the gastric or post-pyloric position; respiratory assistance product processing. Although there is some disagreement regarding specific bundle components among some researchers, VAP reduction has been achieved provided there is a high level of compliance (above 95%) of the core bundle components. With such high adherence, VAP can be effectively prevented. Final considerations: It is considered that the package of preventive measures can save lives and reduce treatment costs, so it is recommended to carry out more observational studies regarding the effectiveness of bundles in ICUs.
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