Os impactos dos bundles na prevenção da pneumonia associada a ventilação mecânica: uma revisão de literatura

Abstract

Introduction: Whistled Pneumonia on Mechanical Ventilation (VAP) is defined by the National Health Surveillance Agency (Anvisa) as pneumonia evident 48 hours after starting mechanical ventilation (MV). VAP has a global prevalence of 15.6%, and general mortality attributed to it can reach rates from 20% to 60%. Objective: To identify, through the scientific literature, the impacts of bundles in the prevention of ventilator-associated pneumonia. Methodology: This is a scientific literature review, addressing the databases indexed in the Virtual Health Library (BVS), Scientific Electronic Library Online (SciELO), Physiotherapy Evidence Database (PEDro), with articles in Portuguese and English. Results: Sixteen articles from 2006 to 2022 were used to carry out the work, in which the impact of the bundle on the prevention of pneumonia associated with mechanical ventilation was verified. Discussion: The bundle was analyzed as the only therapeutic resource, consisting of the following items: head elevation from 30° to 45°, oral hygiene with chlorhexidine 0.12% twice a day or when necessary, verification of the possibility of extubation , reduction of sedation, maintenance of cuff pressure and maintenance of ventilatory circuits Conclusion: The results of the present studies indicate that the use of the bundle package was effective in preventing pneumonia associated with mechanical ventilation. However, with the application of the bundle, some studies did not obtain good results, this may be due to the lack of inputs, such as chlorhexidine 0.12% for oral hygiene, lack of training for the nursing team and physiotherapists.