Ventilator-associated pneumonia (VAP) and ventilator-associated tracheitis (VAT) are common complications of mechanical ventilation, but VAT prevention is often overlooked in favor of VAP prevention. The Clinical Scene Investigator (CSI) team of the cardiac intensive care unit (CICU) at Seattle Children’s Hospital decided to focus on VAT prevention because of the unit’s low VAP rate yet high VAT rate. From August 2020 to January 2021, the CICU VAT rate was 13 cases of VAT per 1000 ventilator days. In 2020, 53% of patients diagnosed with a central line [catheter]–associated bloodstream infection (CLABSI) in the CICU first had VAT with the same organism as the one that caused the CLABSI. This finding indicated that VAT may play a larger role in hospital-acquired infections than previously thought and warranted more focused prevention efforts.

The CSI team created an evidence-based VAT prevention bundle using the mnemonic COMBAT VAT: C, Change equipment; O, Oral care;...

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