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AARC Evidence-Based Clinical Practice Guidelines

Care of the Ventilator Circuit and Its Relation to Ventilator-Associated Pneumonia

Principal author: Dean R Hess PhD RRT FAARC. Writing committee: Thomas J Kallstrom RRT FAARC, Carl D Mottram RRT FAARC, Timothy R Myers RRT-NPS, Helen M Sorenson MA RRT FAARC, and David L Vines MHS RRT.

Summary of Recommendations

Ventilator circuits should not be changed routinely for infection control purposes. The maximum duration of time that circuits can be used safely is unknown.
Evidence is lacking related to ventilator-associated pneumonia (VAP) and issues of heated versus unheated circuits, type of heated humidifier, method for filling the humidifier, and technique for clearing condensate from the ventilator circuit.
Although the available evidence suggests a lower VAP rate with passive humidification than with active humidification, other issues related to the use of passive humidifiers (resistance, dead space volume, airway occlusion risk) preclude a recommendation for the general use of passive humidifiers.
Passive humidifiers do not need to be changed daily for reasons of infection control or technical performance. They can be safely used for at least 48 hours, and with some patient populations some devices may be able to be used for periods of up to 1 week.
The use of closed suction catheters should be considered part of a VAP prevention strategy, and they do not need to be changed daily for infection control purposes. The maximum duration of time that closed suction catheters can be used safely is unknown.
Clinicians caring for mechanically ventilated patients should be aware of risk factors for VAP (eg, nebulizer therapy, manual ventilation, and patient transport).

FULL TEXT: care of the ventilator circuit respir care Hess

Last Updated ( Monday, 08 October 2007 )

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