Intervention
• Use noninvasive positive pressure ventilation in selected populations (II)
• Assess readiness to extubate daily using spontaneous breathing trials in patients
without contraindications (II)
• Avoid unplanned extubations (III)
• Provide regular oral care (ie, toothbrushing or gauze if no teeth) (III)
• Elevate the head of the bed to 30°-45° (III)
• Change ventilator circuits only if visibly soiled or malfunctioning (II)
• Use cuffed endotracheal tubes (III)
• Prevent condensate from reaching the patient (III)
• Interrupt sedation daily (II)
• Prophylactic probiotics (III)
• Utilize endotracheal tubes with subglottic secretion drainage ports for older pediatric
patients expected to require more than 48 or 72 hours of mechanical ventilation (III)
• Systemic antimicrobial therapy for ventilator-associated tracheobronchitis (III)
• Selective oropharyngeal or digestive decontamination (III)
• Oral care with antiseptics, such as chlorhexidine (II)
• Stress ulcer prophylaxis (III)
• Early tracheotomy (III)
• Thromboembolism prophylaxis (III)
• Silver-coated endotracheal tubes (III)
• Closed/in-line suctioning (III)
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