下列哪項措施對於預防呼吸器相關肺炎（VAP）最有效？
Which of the following interventions is most effective in preventing ventilator-associated pneumonia (VAP)?
- AChanging the ventilator circuit every 24 hours每 24 小時更換一次呼吸器管路
- BAdministering prophylactic antibiotics給予預防性抗生素
- CElevating the head of the bed to 30-45 degrees✓ 正解將床頭抬高 30-45 度
- DSuctioning the airway every 2 hours routinely每 2 小時常規進行氣道抽吸
VAP 預防的核心是減少口腔菌叢吸入（Aspiration）。將床頭抬高 30-45 度可減少胃內容物逆流與誤吸。A 選項研究指出頻繁更換管路反而增加汙染；C 不建議常規給予抗生素以免產生抗藥性；D 建議依需抽痰（PRN）而非固定時間，過度抽痰損傷黏膜。
The core of VAP prevention is to reduce aspiration of oral flora. Elevating the head of the bed to 30-45 degrees reduces reflux of gastric contents and aspiration. Studies of option A indicate that frequent circuit changes actually increase contamination; option B is not recommended, as routine prophylactic antibiotics promote resistance; option D should be performed as needed (PRN) rather than at fixed intervals, since excessive suctioning damages the mucosa.
美台臨床皆已採納 Care Bundle 概念，VAP 預防強調口腔清潔與床頭抬高，這已是國際公認指標。