Active Humidification

Ventilator Associated Pneumonia (VAP)

Protecting Patients with VAP Prevention Strategies

Ventilator-associated pneumonia (VAP) is a nosocomial (hospital-acquired) pneumonia that develops more than 48 hours after endotracheal intubation. It is one of the most common infections acquired by adults and children in intensive care units (ICUs) and is a cause of significant patient morbidity and mortality, increased utilization of healthcare resources, and excess cost.1 In fact, a recent review of the clinical and economical consequences of VAP found that patients who develop VAP incur more than $10,000 in additional hospital costs.2 Startling facts like these demonstrate the need for innovations not only to reduce the cost of hospitalization, but more importantly to ensure the safety and well-being of patients.


Condensation Control Options and Related Concerns

When condensation collects in the ventilator circuit, the clinician has two primary options:

OPTION 1. Use a “closed-system” approach that allows for condensate removal without breaking the circuit.

The Hudson RCI® Neptune® Heated Humidifier with ConchaSmart® Technology, featuring the ISO-Gard® Circuit Technology, allows clinicians to meet the unique humidification needs of every patient, while helping to avoid the risks associated with breaking the circuit to manage condensate.

OPTION 2. Open, or break, the circuit to drain the condensate from the tubing or water trap. When opening, or breaking, the circuit, the following consequences must be considered:3,4

  • Potential for contamination of the interior of the circuit
  • Potential for caregiver exposure to condensate during ventilator / water trap disconnection or disposal
  • Potential for cross-contamination of other patients
  • Loss of PEEP and/or de-recruitment of the lung

Because of these potential consequences, the literature indicates that opening the circuit to drain condensate should be avoided, if possible.1,3,4 Guidelines indicate that one of the strategies to minimize contamination of equipment used to care for patients receiving mechanical ventilation is to remove condensate from ventilator circuits and to keep the ventilator circuit closed while doing so.1

It is also recognized that opening the circuit to drain accumulated condensate increases the potential for caregivers to be contaminated. During circuit disconnects, ventilators may generate a high flow through the patient circuit that may aerosolize contaminated condensate, putting both the patient and the clinician at risk for nosocomial infection.3

References:

  1. Coffin SE, Klompas M, Classen D, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals. Infect Control Hospital Epidemiol. 2008; 29;S31-S40.
  2. Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: A systematic review. Crit Care Med. 2005;33:2184-2193.
  3. Restrepo RD, Walsh BK. AARC CPG: Humidification during invasive and noninvasive mechanical ventilation. Respir Care. 2012; 57(5): 782-788.
  4. AARC Evidence-based clinical practice guidelines: Care of the ventilator circuit and its relation to ventilator-associated pneumonia. Respir Care. 2003; 48(9): 869-879.
Teleflex, Comfort Flo, ConchaSmart, Hudson RCI, ISO-Gard and Neptune are trademarks or registered trademarks of Teleflex Incorporated or its affiliates. MC-000331 Rev 4