求英文paper翻譯(呼吸器相關肺炎)

拜託拜託! 不要只有google翻譯貼上來 句子可以越順越好....如用google翻譯麻煩至少順完句子!謝謝 The American Association of Critical-Care Nurses published an evidence-based practice alert in 2006 that offered guidelines for oral care of the mechanically ventilated patient. In addition,Grap and Munro and Collard and Saint recommended raising the head of... 顯示更多 拜託拜託! 不要只有google翻譯貼上來
句子可以越順越好....如用google翻譯麻煩至少順完句子!謝謝
The American Association of Critical-Care Nurses published an evidence-based practice alert in 2006 that offered guidelines for oral care of the mechanically ventilated patient. In addition,Grap and Munro and Collard and Saint recommended raising the head of the bed to an elevation of 30˚ to 40˚, using endotracheal tubes that have a dorsal lumen above the endotracheal cuff,and sporadically changing ventilator circuits.Grap and Munro presented supporting evidence indicating that critically ill patients who are intubated for more than 24 hours are at higher risk for VAP, and therefore, mouth care and oral health should be an important part of nursing care.Current literature identified a problem with adequate oral care in the intubated patient that included the definition and quantification of oral care. Bergmans and colleagues provided evidence that prevention of bacterial colonization of the oropharynx is the key to preventing VAP.The Centers for Disease Control and Prevention guidelines. determined that the primary route of bacterial entry into the lungs is through the oropharynx during episodes of microaspiration.Several studies have verified that removing bacteria from the oropharynx requires the removal of dental plaque, and the only way to remove the plaque is with toothbrushing.Pearson and Hutton and others found that the majority of nurses use a soft Toothette® instead of toothbrushing and that the Toothettes do not remove plaque as effectively as toothbrushes;consequently,oral bacteria can proliferate.Pearson and Hutton completed a controlled trial that compared the ability of foam swabs and toothbrushes to remove dental plaque and to quantify any differences.They concluded that toothbrushing skills must be taught to nurses and clinical support staff.Schleder reviewed the pathogenesis of bacteria; identified risk factors, including colonization of the oropharynx; and recommended the following approaches:
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