Pediatric research
Primary preventive interventions to reduce ventilator-associated pneumonia in neonatal intensive care units: a meta-analysis
By Elmakaty I, Karen O, Kokash R and 4 others.
Abstract
Background
To assess preventive strategies for ventilator-associated pneumonia (VAP) in mechanically ventilated (MV) neonates.
Methods
PubMed, Embase, Web of Science, and Cochrane Library were searched in June 2025. Eligible studies evaluated primary VAP-prevention interventions in neonates receiving MV. Outcomes included odds ratios (ORs), incidence rate ratios (IRRs), and incidence rate differences (IRDs).
Results
Thirty-four studies involving 6,301 neonates were included. Bundle-based quality-improvement packages were associated with lower VAP occurrence (OR = 0.40, 95% CI 0.28-0.57; I² = 37%). MV-adjusted analyses showed lower incidence (IRR = 0.56, 95% CI 0.43-0.73) and 8.33 fewer VAP cases per 1000 MV-days (IRD = -0.0083, 95% CI -0.0127 to -0.0039). Oral care was associated with lower VAP odds (OR = 0.53, 95% CI 0.35-0.81; I² = 3%). Evidence for other interventions was limited and heterogeneous.