Rello et al. also showed that regulation of cuff pressure over 20 cm H2O led to reduced incidence of VAP,[23] which is consistent with the present study. Our results also showed that the incidence of VAP was similar until the fourth day after intervention in both study and control groups. But on the fifth day, the incidence of VAP was significantly lower in the study group, compared to control, which reveals the effect of conducting three simultaneous airway care protocols including regulating the tracheal tube cuff pressure to about 25 cm H2O, maintenance of bed head elevation up to 45°, and oral and subgluteal space suctioning before each position change on the incidence of VAP.