National Trauma Institute prospective evaluation of the ventilator bundle in trauma patients

Martin A. Croce, Karen J. Brasel, Raul Coimbra, Charles A. Adams, Preston R. Miller, Michael D. Pasquale, Chanchai S. McDonald, Somchan Vuthipadadon, Timothy C. Fabian, Elizabeth A. Tolley

Since its introduction by the Institute for Healthcare Improvement, the ventilator bundle (VB) has been credited with a reduction in ventilator-associated pneumonia (VAP). The VB consists of stress ulcer prophylaxis, deep venous thrombosis prophylaxis, head-of-bed elevation, and daily sedation vacation with weaning assessment. While there is little compelling evidence that the VB is effective, it has been widely accepted. The Centers for Medical and Medicaid Services has suggested that VAP should be a "never event" and may reduce payment to providers. To provide evidence of its efficacy, the National Trauma Institute organized a prospective multi-institutional trial to evaluate the utility of the VB.