Ventilator-associated pneumonia: diagnosis, treatment, and prevention

Abstract

While critically ill patients experience a life-threatening illness, they commonly contract ventilator-associated pneumonia. This nosocomial infection increases morbidity and likely mortality as well as the cost of health care. This article reviews the literature with regard to diagnosis, treatment, and prevention. It provides conclusions that can be implemented in practice as well as an algorithm for the bedside clinician and also focuses on the controversies with regard to diagnostic tools and approaches, treatment plans, and prevention strategies.

Figures

FIG. 1.

Algorithm for diagnosis and treatment of VAP. (©American Thoracic Society. Adapted from the American Journal of Respiratory and Critical Care Medicine [5] with permission.) Antibiotic choice can be tailored to the pathogens’ last sensitivity report should QEA surveillance cultures be obtained twice weekly and should the growth level exceed 100,000 CFU/ml (.)

FIG. 2.

Pharmacodynamic and pharmokinetic approach to antibiotic therapy.

FIG. 3.

Potential strategies to prevent VAP.