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Prevention of Ventilator-Associated Pneumonia and
Ventilator-Associated Conditions: A Randomized Controlled Trial
With Subglottic Secretion Suctioning
Damas, P et al. Crit Care Med. 2015 Jan;43(1):22-30
1.Center for Disease Control and Prevention : Surveillance for ventilated associated events. Available at : https://www.cdc.gov/nshn/acute-care-hospital/vae/index.html. Accessed September 19, 2014 2.Klompas M : Complications of mechanical ventilation-The CDC’s new surveillance paradigm. N Engl J Med 2013;368:1472–1475
VAEサーベイランスの概要 安定した2日間以上の人工呼吸管理
安定/改善傾向の後、下記の変化が2日以上続く PEEP≧3cmH2O もしくは FIO2≧0.2
VACの状態を満たし、かつ下記の2項目を満たす 1.体温:>38℃/<36℃または白血球数 ≧12,000 or ≦4,000 2.抗菌薬開始後4日以上経過
3. Dezfulian C, Shojania K, Collard HR, et al: Subglottic secretion drainage for preventing ventilator-associated pneumonia. Am J Med 2005;118:11–18 4.Lacherade JC, De Jonghe B, Guezennec P, et al: Intermittent subglottic secretion drainage and ventilator- associated pneumonia: A multi-center trial. Am J Respir Crit Care Med 2010; 182:910–917