*2.4.3. Prevention*

One important risk factor for developing pneumonia is retained secretion. So, pulmonary toilet is important in these patients. Appropriate positioning and cough assistance can be useful for clearing retained secretions. Sometimes early intubation may be necessary to prevent secretion retaining by frequent suctioning [48]. Using effective oral care with antiseptics is associated with the reduction of the incidence of ventilator-associated pneumonia. Oral care solutions have been widely used to prevent ventilator-associated pneumonia [49]. Routine cleaning and disinfection of ventilators can play an important role in VAP prevention and management approach [53].
