Critically ill patients who are intubated are at risk for development of ventilator-associated pneumonia (VAP), a subset of ventilator- associated events. The mortality associated with VAP is significant. Published mortality rates are from 0% to 70%, depending on the population studied, clinical condition, and timing of VAP identifiction and antibiotic administration.

Collaborate to identify patients who may benefit from noninvasive positive pressure ventilation (NIPPV) to prevent the need for intubation.

Assess readiness to extubate daily through combine spontaneous awakening trials and spontaneous breathing trials, unless clinically contraindicated.

Maintain and improve physical conditioning through early exercise and mobility.

Elevate the head of bed to 30° to 45° unless clinically contraindicated in patients receiving mechanical ventilation, and patients at high risk for aspiration.

Minimize pooling of secretions above the endotracheal tube cuff by using an endotracheal tube with subglottic suction capability in patients with anticipated intubation greater than 48 to 72 hours....

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