Editor-We read with interest the article by Bloos and colleagues1 describing their experience of introducing a ventilator care bundle. Their claim that incomplete adoption of their adapted ventilator bundle led to a statistically significant reduction in length of mechanical ventilation, while showing no positive effect upon the rate of ventilator-associated pneumonia (VAP), may be misleading given the differences between the two sample populations. Their adopted ventilator bundle differed from the Institute for Health Improvement's (IHI) approved bundle in the decision to omit the 'sedation vacation' or 'readiness to wean' component.
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