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The cuff at the lower end of the ET tube is used to seal the airway during mechanical ventilation and
minimize aspiration into the lower respiratory tract. A routine part of airway care is to measure and monitor
ET tube cuff pressure to assess for a tracheal seal. Cuff pressure should be maintained above 20 cm
H2O to minimize the aspiration risk, but below the tracheal mucosal capillary perfusion pressure of 25 to
30 cm H2O to minimize tracheal erosion.
Although the bundle has been documented to decrease mortality and minimize the aspiration risk, it lacks
an intervention to decolonize the oral cavity. Thus, an opportunity exists to improve healthcare quality and
redefine strategies for VAP prevention.
The authors dissertation study found that the optimal bundle for reducing VAP includes these three
interventions: