Prevention of Ventilator-Associated Pneumonia
Authors: Harold R. Collard, Sanjay Saint, Michael A. Matthay
Journal: Annals of Internal Medicine (2004)

Letters16 March 2004Prevention of Ventilator-Associated PneumoniaHarold R. Collard, MD, Sanjay Saint, MD, MPH, and Michael A. Matthay, MDHarold R. Collard, MDFrom University of Colorado Health Sciences Center, Denver, CO 80262; Ann Arbor Veterans Affairs Medical Center and the University of Michigan Health System, Ann Arbor, MI 48109; and University of California, San Francisco, San Francisco, CA 94143.Search for more papers by this author, Sanjay Saint, MD, MPHFrom University of Colorado Health Sciences Center, Denver, CO 80262; Ann Arbor Veterans Affairs Medical Center and the University of Michigan Health System, Ann Arbor, MI 48109; and University of California, San Francisco, San Francisco, CA 94143.Search for more papers by this author, and Michael A. Matthay, MDFrom University of Colorado Health Sciences Center, Denver, CO 80262; Ann Arbor Veterans Affairs Medical Center and the University of Michigan Health System, Ann Arbor, MI 48109; and University of California, San Francisco, San Francisco, CA 94143.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-6-200403160-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Systematic reviews aim to summarize existing data identified through specified selection criteria and, at times, make recommendations on the basis of these data. We believe that well-done systematic reviews illustrate the strength of evidence-based medicine, not the “absurdity.” Recommendations in our article were made not on the basis of our preferences but after careful evaluation of the evidence.Ricard and Dreyfuss contest our review of 2 meta-analyses comparing sucralfate with H2-antagonists, claiming the studies reached opposite conclusions (1, 2). This is incorrect. Both studies found sucralfate to be associated with a decreased incidence of ventilator-associated pneumonia compared with ...References1. Messori A, Trippoli S, Vaiani M, Gorini M, Corrado A. Bleeding and pneumonia in intensive care patients given ranitidine and sucralfate for prevention of stress ulcer: meta-analysis of randomised controlled trials. BMJ. 2000;321:1103-6. [PMID: 11061729] CrossrefMedlineGoogle Scholar2. Cook DJ, Reeve BK, Guyatt GH, Heyland DK, Griffith LE, Buckingham L, et al . Stress ulcer prophylaxis in critically ill patients. Resolving discordant meta-analyses. JAMA. 1996;275:308-14. [PMID: 8544272] CrossrefMedlineGoogle Scholar3. Kollef MH. Selective digestive decontamination should not be routinely employed. Chest. 2003;123:464S-8S. [PMID: 12740230] CrossrefMedlineGoogle Scholar4. Ebner W, Kropec-Hubner A, Daschner FD. Bacterial resistance and overgrowth due to selective decontamination of the digestive tract. Eur J Clin Microbiol Infect Dis. 2000;19:243-7. [PMID: 10834811] CrossrefMedlineGoogle Scholar5. Davis K, Evans SL, Campbell RS, Johannigman JA, Luchette FA, Porembka DT, et al . Prolonged use of heat and moisture exchangers does not affect device efficiency or frequency rate of nosocomial pneumonia. Crit Care Med. 2000;28:1412-8. [PMID: 10834688] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Colorado Health Sciences Center, Denver, CO 80262; Ann Arbor Veterans Affairs Medical Center and the University of Michigan Health System, Ann Arbor, MI 48109; and University of California, San Francisco, San Francisco, CA 94143. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrevention of Ventilator-Associated Pneumonia: An Evidence-Based Systematic Review Harold R. Collard , Sanjay Saint , and Michael A. Matthay Prevention of Ventilator-Associated Pneumonia Jean-Damien Ricard and Didier Dreyfuss Selective Decontamination of the Digestive Tract and Prevention of Ventilator-Associated Pneumonia Paul Baines and Hendrik van Saene Selective Decontamination of the Digestive Tract and Prevention of Ventilator-Associated Pneumonia Harold R. Collard , Sanjay Saint , and Michael A. Matthay Metrics Cited ByDescontaminación digestiva selectiva. ¿Por qué no aplicamos la evidencia en la práctica clínica?Selective Decontamination of the Digestive Tract and Prevention of Ventilator-Associated PneumoniaPaul Baines, MD and Hendrik van Saene, MD 16 March 2004Volume 140, Issue 6Page: 486-487KeywordsDecontaminationEvidence based medicineGastrointestinal tractHemorrhageIntubationNoninvasive ventilationPneumoniaSystematic reviewsVentilator associated pneumoniaVentilators ePublished: 16 March 2004 Issue Published: 16 March 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...