Torres A, Serra-Batlles J, Ros E, et al. Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position. Annals of Internal Medicine. Apr 1992;116(7):540-543.

Randomized cross-over study of 19 patients on mechanical ventilation. Tc99m sulphur colloid labeling of stomach contents was performed, followed by sequential radioactivity counts in endobronchial secretions over a 5h period. Patients were randomized to the prone position or semi-recumbency and studied 12h later; the study was repeated 48h later with the patient in the alternate position. Radioactive counts were higher, indicating aspiration of gastric contents, in the prone position, and increased over time.

Task Force on Guidelines. Guidelines for standards of care for patients with acute respiratory failure on mechanical ventilatory support. Task Force on Guidelines; Society of Critical Care Medicine. Critical Care Medicine. Feb 1991;19(2):275-278.

This is one of a series of guidelines published by the Task Force on Guidelines of the Society of Critical Care Medicine.  It specifies a number of minimum standards for the care of critically ill patients on mechanical ventilation, including personnel, monitoring equipment, support services, and equipment. There is a brief discussion of clinical management, but no discussion of the supporting evidence.

Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. Morbidity and Mortality Weekly Report Recommendations Report. 2004;53(RR-3):1-36.

This is a 179-page document, which gives definitive guidance on prevention of all types of health-care associated pneumonia, including ventilator-associated pneumonia.

Rello J, Ollendorf DA, Oster G, et al. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest. 2002;122(6):2115-2121.

Retrospective matched cohort study from a large US inpatient database examining risk factors for, and the mortality, duration of ventilation, and cost associated with ventilator-associated pneumonia.

MacIntyre NR, Cook DJ, Ely EW, Jr, et al. Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest. 2001;120(6 Suppl):375S-395S.

A clinical practice guideline, giving detailed recommendations on weaning patients from mechanical ventilation. The paper reviews the evidence that unnecessary delays in weaning increase the complication rate for mechanical ventilation, including pneumonia, as well as the cost. The guidelines draw on an AHRQ-sponsored summary of the literature published in 1999 by the McMaster University Evidence-Based Practice Center.

Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. New England Journal of Medicine. 2000;342(20):1471-1477.

Randomized controlled trial in 128 adult patients on mechanical ventilation, randomized to daily interruption of sedation irrespective of clinical state or interruption at the clinician’s discretion. Daily interruption resulted in a marked and highly significant reduction in time on mechanical ventilation.

Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Critical Care Medicine. 2002;30(1):119-141.

A clinical practice guideline prepared by the American College of Critical Care Medicine of the Society for Critical Care Medicine.  It gives detailed recommendations for ensuring adequate sedation and analgesia for patients on the ICU.

Ibrahim EH, Tracy L, Hill C, Fraser VJ, Kollef MH. The occurrence of ventilator-associated pneumonia in a community hospital: Risk factors and clinical outcomes. Chest. 2001;120(2):555-561.

Prospective, single-center cohort study over 22 months of the risk factors for and mortality from ventilator-associated pneumonia in a medical and surgical ICU in a 500-bed community hospital.

Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 Suppl):338S-400S.

A clinical practice guideline issued as part of the Seventh American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy: Evidence-based Guidelines. The recommendations cover patients undergoing surgery, trauma patients, acutely ill medical patients, and patients admitted to the intensive care unit.

Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogue S, Ferrer M. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: A randomised trial. Lancet. 1999;354(9193):1851-1858.

Randomized controlled trial in 86 mechanically ventilated patients assigned to semi-recumbent or prone body position demonstrating the excess risk of ventilator-associated pneumonia associated with prone position.