Division of Pulmonary and Critical Care Medicine, Box 3911, Duke University Medical Center, Durham NC 27710, USA.
Respir Care. 2010 Feb;55(2):184-96; discussion 196-7.
Ventilator-associated pneumonia (VAP) is a common and serious complication of mechanical ventilation via an artificial airway. As with all nosocomial infections, VAP increases costs, morbidity, and mortality in the intensive care unit (ICU). VAP prevention is a multifaceted priority of the intensive care team, and can include the use of specialized artificial airways and heat-and-moisture exchangers (HME). Substantial evidence supports the use of endotracheal tubes (ETTs) that allow subglottic suctioning; silver-coated and antiseptic-impregnated ETTs; ETTs with thin-walled polyurethane cuffs; and HMEs, but these devices also can have adverse effects. Controversy still exists regarding the evidence, cost-effectiveness, and disadvantages and risks of these devices.
呼吸机相关性肺炎（VAP）是通过人工气道进行机械通气的常见且严重的并发症。与所有医院获得性感染一样，VAP 会增加重症监护病房（ICU）的成本、发病率和死亡率。VAP 的预防是重症监护团队的一个多方面的优先事项，包括使用专门的人工气道和热湿交换器（HME）。大量证据支持使用允许声门下吸引的气管内导管（ETT）；涂银和抗菌浸渍的 ETT；具有薄壁聚氨酯袖口的 ETT；和 HME，但这些设备也可能有不良影响。关于这些设备的证据、成本效益以及优缺点仍然存在争议。
