Ventilator-associated Pneumonia

• Ventilator-associated pneumonia (VAP) is a well known complication of mechanical ventilation (MV) and is associated with increased duration of MV, hospital length of stay, and cost.
• VAP is commonly associated with multi-drug resistant organisms, including Pseudomonas, Acinetobacter, Klebsiella, and Enterobacteriaceae.
• Given the significant impact upon morbidity, a number of organizations have recommended "bundles" of care for the prevention of VAP.
• Important measures for the prevention of VAP include:
  • Strict hand hygiene
  • Head of bed elevation to 30-45 degrees
  • Closed endotracheal suctioning
  • Maintaining endotracheal tube cuff pressure > 20 cm H2O
  • Oral chlorhexidine rinses
  • Orogastric tube placement

References

Kollef MH. Ventilator-associated complications, including infection-related complications. Crit Care Clin 2013; 29:33-50.