A 52-year-old man is intubated and ventilated in the intensive care unit after repair of a thoracoabdominal aortic aneurysm. Which of the following will most effectively decrease his risk of ventilator-associated pneumonia?

Ventilator-associated pneumonia (VAP) is a parenchymal lung infection manifesting more than 48 hours after initiation of mechanical ventilation. It occurs in 10-25 percent of patients intubated for longer than 48 hours and is one of the most commonly acquired infections in intensive care unit (ICU) patients. Prevention of VAP has been a focus of quality initiatives in the ICU. Mechanisms of VAP include:

Methods to decrease the risk of VAP include:

A specialized tracheal tube has been developed in an effort to reduce the volume of oropharyngeal secretions pooling above and leaking around the tracheal tube cuff. Use of this tube, which has an additional lumen for...

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