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. 2021 Sep 1;25:323. doi: 10.1186/s13054-021-03744-w

Table 1.

Summary of findings from Cochrane reviews of VAP prevention interventions a

Intervention Ref VAP incidence (per 1000 patients) Mortality incidence (per 1000 patients)
Control Intervention RR; (95% CI) n/N Control Intervention RR; (95% CI) n/N
Semi-recumbent b [20] 316 139 0·44; 0·11–1·77 3/419 276 240 0·87; 0·59–1·27 2/307
HME c [21] 167 155 0·93; 0·73–1·19 13/2251 247 257 1·03; 0·89–1·2 12/1951
Probiotic d [22] 309 238 0·7; 0·52–0·95 8/1018 214 186 0·84; 0·58–1·22 5/703
Chlorhexidine e [23] 243 180 0·75; 0·62–0·91 18/2451 222 242 1·09; 0·96–1·23 14/2014
Tooth brushing f [23] 253 206 0·69; 0·44–1·09 5/889 269 237 0·87; 0·7–1·09 5/889
TAP + PPAP g [1] 417 179 0·43; 0·35–0·53 17/2951 303 255 0·84; 0·73–0·96 18/5290
TAP (alone) h [1] 324 162 0·50; 0·36–0·69 13/1848 305 296 0·97; 0·87–1·07 15/3274
TAP + PPAP (versus PPAP) i, j [1] 303 278 0·82; 0·58–1·16 6/247 237 221 0·92; 0·72–1·18 7/1039

an/N is number of participants/number of studies

bSemi-recumbent position; pneumonia is microbiologically confirmed VAP at > 48 h and mortality is ICU mortality at > 48 h

cHME (heat and moisture exchanger); pneumonia measured at a median 4 days (from Analysis 1.3 on page 65 of ref [21]) and mortality measured at a median 8 days

dProbiotic; pneumonia is VAP measured at a median 37 days and mortality measured at a median 35 days

eChlorhexidine (mouth rinse or gel); pneumonia is VAP measured at a median 1 month and mortality measured at a median 1 month

fToothbrushing; pneumonia is VAP measured at a mean 1 month and mortality measured at a mean 1 month

gTAP + PPAP studies; pneumonia is respiratory tract infection at unspecified follow up and mortality is at unspecified follow up. These studies resemble those having designs as in Fig. 1b

hTAP alone; pneumonia is respiratory tract infection at unspecified follow up (note this does not include 6 studies for which the control group received PPAP) and mortality is at unspecified follow up. These studies resemble those having designs as in Fig. 1a

iTAP + PPAP versus PPAP (duplex studies); pneumonia is respiratory tract infection at unspecified follow up and mortality is at unspecified follow up. These studies resemble those having designs as in Fig. 1c

jNote that only one study [10] having a NCC design (as in Fig. 1d) is included within the systematic review of TAP[1]