What is ventilator-associated pneumonia (VAP) and what are the risk factors for its development?

Updated: Apr 07, 2020
  • Author: Allon Amitai, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

VAP is defined as pneumonia in a mechanically ventilated patient that is not clinically present at the time of intubation. [26] The time frame for development of VAP is typically 48 hours or more after intubation, as this is when the disease typically manifests itself clinically. VAP has been implicated as the most common infectious complication occurring in ICU patients and results in prolonged ICU and hospital lengths of stay, prolonged duration of mechanical ventilation, and overall increased cost of care. [10]

Evidence suggests that prehospital and ED intubation, in addition to ED length of stay, are independent risk factors for the development of VAP. [10, 27] These findings, when combined with the significant morbidity and mortality associated with VAP, confer upon the ED physician a responsibility to implement measures to reduce the risk of VAP in the ED. These interventions are aimed at reducing the risk of aspiration and decreasing bacterial colonization.


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