— 安全與感染控制 · HARD · SATA —
下列哪些做法可有效降低呼吸器相關肺炎（VAP）的風險？（選所有適合的）
Which of the following practices effectively minimizes the risk of ventilator-associated pneumonia (VAP)? (Select all that apply.)
- AElevating the head of the bed to 30-45 degrees✓ 正解將床頭抬高 30-45 度
- BDaily sedation vacation for readiness-to-wean assessment✓ 正解每日暫停鎮靜以評估脫離呼吸器的準備情況
- CProviding regular oral care with chlorhexidine✓ 正解定期使用氯己定進行口腔護理
- DFrequent changes of the ventilator circuit tubing頻繁更換呼吸器管路
- EMaintaining endotracheal tube cuff pressure✓ 正解維持氣管內管氣囊壓力
— Explanation · 中文詳解 —
VAP 預防護理包（Bundle）包括：床頭抬高（防吸入）、每日喚醒評估（早日拔管）、Chlorhexidine 口腔護理（降低菌落）、維持適當氣囊壓力（防微吸入）。頻繁更換管路反而增加汙染風險，現已不建議作為常規。
The VAP prevention bundle includes: head-of-bed elevation (to prevent aspiration), daily sedation vacation (to facilitate earlier extubation), chlorhexidine oral care (to reduce bacterial colonization), and maintenance of appropriate endotracheal cuff pressure (to prevent micro-aspiration). Frequent changes of ventilator circuit tubing actually increase the risk of contamination and are no longer recommended as routine practice.
✦ 台美臨床差異
兩地皆推動 VAP Bundle，針對管路更換的規範皆已捨棄「定期更換」原則。