Nosocomial infection

Endotracheal intubation bypasses normal defence mechanisms. Ciliary activity and cellular morphology in the tracheobronchial tree are altered. The requirement for endotracheal suction further increases susceptibility to infection. In addition, the normal heat and moisture exchanging mechanisms are bypassed requiring artificial humidification of inspired gases. Failure to provide adequate humidification increases the risk of sputum retention and infection. Maintaining ventilated patients at 30° upright head tilt has been shown to reduce the incidence of nosocomial pneumonia.

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