Don’t replace regularly the mechanical ventilator circuits to reduce the risk of VAP (Ventilator Associated Pneumonia)

Type of practice

Other health practices

Topic Area


Routine replacement of the mechanical ventilator circuits is not recommended. These should only be replaced if they are visibly dirty (with plenty of moisture and / or secretions). VAPs produce increased morbidity and mortality and rise the costs for hospitalized patients in intensive care (ICU) with the presence of endotracheal tube (ETT). Routine replacement of the ventilation circuit does not decrease the risk of infection. Effective interventions to reduce VAPs can be inserted in a “bundle” (combination of preventive strategies) which considers: keeping the patients’ head elevated at least 30 ° (compatibly with any constrained position due to functional limitations); hygiene of the oral cavity with an alcoholic solution of chlorhexidine mouthwash to 0.12% at least every 6 hours; hand hygiene of healthcare workers; use of ETT with subglottic suction lumen; early extubation and mobilization.


1. Levy MM. A new definition of ventilator-associated pneumonia: far from perfect, better than before. Ann Am Thorac Soc 2013 Dec; 10(6): 644-5.
2. Rosenthal VD, Bijie H, Maki DG, Mehta Y, Apisarnthanarak A, Medeiros EA, et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009. Am J Infect Control 2012; 40(5): 396-407.
3. Eom JS, Lee MS, Chun HK, Choi HJ, et al. The impact of a ventilator bundle on preventing ventilator-associated pneumonia: A multicenter study. Am J Infect Control. 2014 Jan; 42(1): 34-7.
4. Mietto C, Pinciroli R, Patel N, Berra L. Ventilator Associated Pneumonia: Evolving Definitions and Preventive Strategies. Respir Care. 2013 Jun; 58(6): 990-1007.

Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.