Table 3. Components of the Spanish VAP prevention bundle (36).

Basic mandatory measures

Education and training in appropriate airway management

Strict hand hygiene for airway management

Cuff pressure control

Oral hygiene with chlorhexidine

Semi-recumbent positioning

Promote procedures and protocols, which safely avoid or reduce time on ventilator

Avoid scheduled change of ventilator circuit, humidifiers and endotracheal tubes

Highly recommended measures

Selective decontamination of the digestive tract or selective decontamination of the oropharynx

Aspiration of subglottic secretions

Short course of intravenous antibiotic in severe trauma patients

VAP, ventilator-associated pneumonia.