Pneumonia, Ventilator-associated (VAP)

VAP = pneumonia that develops >48-72 hours after intubation.

Prevention:

• elevate head of bed 30°- 45°
• remove NG, ET tubes ASAP
• appropriate infection control measures, including hand hygiene in healthcare workers.

Diagnosis:

NB: Start antibiotics as soon as diagnosis is considered likely.

- Endotracheal (ET) aspirate with Gram stain and C&S recommended. May be significant if increased purulence (3-4+ WBC), intracellular organisms present, and/or predominant organism.

- Bronchoscopically obtained specimens may be considered in immunocompromised patients.

Treatment:

- Insufficient evidence that administration of topical (nebulized or instilled via ET tube) antibiotics as an adjunct to systemic antibiotics is beneficial.