In the surgical ICU the overall VAP rate was 45.1 per 1,000 ventilator-days in 1997 and 27.9 per 1,000 ventilator-days in 1998, resulting in a reduction of 17.2 per 1,000 ventilator days (incidence rate difference, 17.2; 95% confidence interval (CI): 2.85 - 31.56).
In the medical ICU the overall VAP rate was 22.4 per 1,000 ventilator-days in 1997 and 11.6. per 1,000 ventilator-days in 1998, resulting in a reduction of 10.8 per 1,000 ventilator-days (incidence rate difference, 10.8; 95% CI: 4.65 -16.91).
A reduction in the VAP rate was observed when the heads of the beds were elevated (when not contraindicated), when sterile water for enteral feeding and one-way enteral valves were introduced, and when new beds that elevated more easily were purchased.
There was a further reduction in the VAP rate when the changing of the in-line suction catheters was prolonged from 24 to 72 hours.
The authors did not provide any justification for not recording the VAP rates when the in-line suction catheters were changed as needed.