publicdata/ahrq-gov
1
0
Fork 0
Code Issues Pull requests Projects Releases Packages Wiki Activity Actions
ahrq-gov/archive.ahrq.gov/research/aug03/0803RA8.htm
Scott Williams 58222b51ed Initial commit
2025-02-28 14:14:25 -05:00

151 lines
No EOL
12 KiB
HTML
Raw Blame History

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>Research Activities, August 2003: Outcomes/Effectiveness Research: Certain hospital practices may reduce the incidence of pneumonia requiring mechanical ventilation among critically ill patients</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<!-- "metadata" -->
<meta name="Title" content="Research Activities, August 2003" />
<meta name="keywords" content="Agency for Health Care Policy and Research, Agency for Healthcare Research and Quality, AHRQ, AHCPR, AIDS/HIV, ambulatory care, benchmark, child, cost, elderly, health cost, healthcare cost, hospital, long-term care, managed care, markets, mental health, methodology, minority health, nursing, nursing homes, outcome research, out-of-pocket spending, patient care, primary, primary care, research, rural, spending, study, Translating Research Into Practice, TRIP" />
<meta name="description" content="August 2003 issue of online newsletter summarizing published findings from AHRQ-funded studies, new AHRQ publications and products, and funding opportunities." />
<meta name="creator" content="Agency for Healthcare Research and Quality (AHRQ)" />
<meta name="datecreated" content="August 2003" />
<meta name="datereviewed" content="August 2003" />
<meta name="language" content="English" />
<!-- end metadata -->
<link href="/includes/archive.css" rel="stylesheet" type="text/css" />
<link href="/includes/ahrqstyleprint_arch.css" rel="stylesheet" type="text/css" media="print" />
<script>
(function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){
(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),
m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)
})(window,document,'script','//www.google-analytics.com/analytics.js','ga');
ga('create', 'UA-75759936-1', 'auto');
ga(' set', 'anonymizeIp', true);
ga('send', 'pageview');
</script></head><body><!-- Google Tag Manager -->
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-W4DST4"
height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
'//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
})(window,document,'script','dataLayer','GTM-W4DST4');</script>
<!-- End Google Tag Manager -->
<noscript>
Your browser doesn't support JavaScript. Please upgrade to a modern browser or enable JavaScript in your existing browser.
</noscript>
<!-- Page Header v2.0 -->
<a name="top" id="top"></a>
<!--Begin Banner CodeS-->
<div id="ahrqbanner">
<div class="hhsportion">
<a href="#h1" class="skipnav">Skip Navigation</a>
<a href="http://www.hhs.gov" title="U.S. Department of Health and Human Services">
<img src="/images/hhs_banner.gif" alt="U.S. Department of Health and Human Services" />
</a>
<a href="http://www.hhs.gov" title="www.hhs.gov" class="hhsright">
<img src="/images/hhs_link.gif" alt="www.hhs.gov" />
</a>
</div>
<div class="ahrqportion">
<a href="/" title="Archive: Agency for Healthcare Research Quality">
<img src="/images/ahrq_banner.gif" alt="Agency for Healthcare Research Quality" />
</a><form name="searchForm" method="get" action="https://search.ahrq.gov/search" id="banner_searchform">
<label for="search" style="z-index:-1;position:relative;margin-right:-65px; font-size:0px;">Search</label>
<input name="q" type="text" value=" Search Archive" size="11" onfocus="this.value='';" class="gotext" label="Search archive" id="search" />
<input type="hidden" name="entqr" value="0" />
<input type="hidden" name="output" value="xml_no_dtd" />
<input type="hidden" name="proxystylesheet" value="ARCHIVE_Front_End" />
<input type="hidden" name="client" value="ARCHIVE_Front_End" />
<input type="hidden" name="site" value="ARCHIVE_AHRQ_GOV" />
<input src="/images/topbn_GoButton.gif" class="gobtn" name="Submit" onclick="javascript:document.searchForm.submit();" type="image" alt="Search" />
</form>
<a href="https://www.ahrq.gov/" class="ahrqright">www.ahrq.gov</a>
</div><div class="ahrqlinks"><a href="https://www.ahrq.gov/">AHRQ Home&#8212;Live Site</a> | <a href="/">Archive Home</a> | <a href="/sitemap.htm">Site Map</a> <!-- | &nbsp;<img src="/images/envelope1.jpg" alt="" width="21" height="14" /><a href="https://subscriptions.ahrq.gov/service/multi_subscribe.html?code=USAHRQ">E-mail Updates</a> --></div>
</div>
<div id="PrintBanner">
<img src="/images/printbanner_arch.jpg" alt="Archive print banner" />
</div>
<a name="h1"></a>
<!-- End banner code -->
<!-- End of Page header -->
<!-- Content Body -->
<div id="mainContent">
<table width="100%" border="0" cellspacing="0" cellpadding="0" >
<tr valign="top">
<td width="70%">
<!-- Center Content section -->
<table width="100%" border="0" cellpadding="0" cellspacing="0" style="margin-left:10px; margin-right:10px;margin-top:5px" summary="This table gives the layout format of the bread crumb area and the center content area.">
<!--DWLayoutTable-->
<tr>
<td class="crumb_link"><div id="crumbContent">
<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> &gt; <a href="/research/resarch.htm" class="crumb_link"><em>Research Activities</em> Archive</a> &gt; <a href="." class="crumb_link">August 2003</a></span></p>
</div>
</td>
</tr>
<tr>
<td><h1><a name="h1" id="h1"></a> Outcomes/Effectiveness Research</h1>
</td>
</tr>
<tr>
<td><div id="centerContent"><div class="headnote">
<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
<h2><a name="head7">Certain hospital practices may reduce the incidence of pneumonia requiring mechanical ventilation among critically ill patients</a></h2>
<p>From 10 to 25 percent of critically ill patients develop pneumonia severe enough to require mechanical ventilation. Colonization of the oropharynx and the stomach with potentially pathogenic organisms precedes the development of ventilator-associated pneumonia in most patients, probably due to microaspiration of oropharyngeal or gastric secretions contaminated with these organisms. Following a systematic review of studies on methods to prevent ventilatory-associated pneumonia, researchers at the University of California, <a href="https://www.ahrq.gov/research/findings/evidence-based-reports/centers/ucsfepc.html">San Francisco-Stanford University Evidence-based Practice Center</a> (EPC) found strong evidence that several hospital practices could help to prevent this serious problem. The EPC is supported by the Agency for Healthcare Research and Quality (contract 290-97-0013).</p>
<p>All eligible patients should be put in a semi-recumbent position to reduce risk for gastroesophageal reflux and aspiration. Sucralfate rather than H2-antagonists should be used to prevent stress ulcers in patients at low to moderate risk for gastrointestinal tract bleeding. H2-antagonists and antacids may increase gastric pathogenic organisms, since these organisms increase with decreasing gastric acidity, and thus increase the risk for ventilator-associated pneumonia. Sucralfate, an alternative prophylactic agent that does not affect gastric pH, may not increase this risk.</p>
<p>Subglottic secretions should be aspirated to prevent their accumulation above the endotracheal tube cuff where they can contribute to the risk of aspiration, particularly in patients requiring more than 3 days of mechanical ventilation. Oscillating beds for surgical patients or patients with neurologic problems can minimize their immobility. This helps, since immobility impairs clearance of bronchopulmonary secretions that increase the risk for ventilator-associated pneumonia. Selective digestive tract decontamination is not recommended because routine use may increase antimicrobial resistance. </p>
<p>For more information, see "Prevention of ventilator-associated pneumonia: An evidence-based systematic review," by Harold R. Collard, M.D., Sanjay Saint, M.D., M.P.H., and Michael A. Matthay, M.D., in the March 2003 <em>Annals of Internal Medicine</em> 138(6), pp. 494-501.</p>
<p><strong>Editor's Note:</strong> Copies of AHRQ Evidence Report/Technology Assessment No. 43, <em><a href="https://www.ahrq.gov/research/findings/evidence-based-reports/er43/ptsafety/">Making Health Care Safer: A Critical Analysis of Patient Safety Practices</a></em> (AHRQ Publication No. 01-E058, full report, and 01-E057, summary), Shojania, K.G., Duncan, B.W., McDonald, K.M., and Wachter, R.M., editors, are available from the <a href="https://www.ahrq.gov/research/publications/order/order-research-activities.html">AHRQ Publications Clearinghouse</a>.</p>
<p class="size2"><a href=".">Return to Contents</a><br />
<a href="0803RA9.htm">Proceed to Next Article</a></p>
<div class="footnote">
<p> The information on this page is archived and provided for reference purposes only.</p></div>
<p>&nbsp;</p>
</div>
</td>
</tr>
</table>
<!-- End of Center Content section -->
</td>
</tr>
</table>
</div>
<!-- End of Content Body -->
<!-- Footer graphic 1.2-->
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tr>
<td width="125" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_1.jpg" width="125" alt="AHRQ" /></td>
<td width="100%" background="/images/bottom_ahrq_bkg.jpg" ><img src="/images/bottom_ahrq_bkg.jpg" width="10" height="34" alt="" /></td>
<td width="310" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_2.gif" alt="Advancing Excellence in Health Care" width="310" height="34" /></td>
</tr>
</table>
<!-- Footer links section -->
<div id="banner_Footer2"><p> <a href="https://www.ahrq.gov/">AHRQ Home</a> | <a href="https://info.ahrq.gov" class="footer_navlink">Questions?</a> | <a href="https://www.ahrq.gov/contact/index.html" class="footer_navlink">Contact AHRQ</a> | <a href="https://www.ahrq.gov/sitemap.html" class="footer_navlink">Site Map</a> | <a href="https://www.ahrq.gov/policy/electronic/accessibility/index.html" class="footer_navlink">Accessibility</a> | <a href="https://www.ahrq.gov/policy/electronic/privacy/index.html" class="footer_navlink">Privacy
Policy</a> | <a href="https://www.ahrq.gov/policy/foia/index.html" class="footer_navlink">Freedom of Information Act</a> | <a href="https://www.ahrq.gov/policy/electronic/disclaimers/index.html" class="footer_navlink">Disclaimers</a> | <a href="http://www.hhs.gov/open/recordsandreports/plainwritingact/index.html" class="footer_navlink">Plain Writing Act</a> <br />
<a href="http://www.hhs.gov" class="footer_navlink">U.S. Department of Health &amp; Human Services</a> | <a href="http://www.whitehouse.gov" class="footer_navlink">The White House</a> | <a href="http://www.usa.gov" class="footer_navlink">USA.gov: The U.S. Government's Official Web Portal</a></p>
</div>
<div id="banner_Footeraddress"><p>Agency for Healthcare Research and Quality <img src="/images/bottom_dot.gif" alt="" /> 5600 Fishers Lane Rockville, MD 20857 <img src="/images/bottom_dot.gif" alt="" /> Telephone: (301) 427-1364</p></div>
<!-- End of Footer links section -->
</body>
</html>
Reference in a new issue View git blame Copy permalink