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A core set of clinical practices — head-of-bed elevation, sedation infusion interruptions, spontaneous breathing trials, thromboprophylaxis, stress ulcer prophylaxis, chlorhexidine gluconate (CHG) oral hygiene — is now used in many hospitals to prevent ventilator-associated pneumonia (VAP). However, the clinical effectiveness of each practice when used in a bundle has not been well assessed. Investigators at a single academic medical center performed a retrospective cohort study to address this issue. They collected data on adherence to each practice and outcome measures in 5539 consecutive patients who underwent 3 or more days of mechanical ventilation in six types of intensive care units from 2009 through 2013.
Efficacy of the individual b…