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Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. As such, VAP typically affects critically ill persons that are in an intensive care unit (ICU).

Causes

VAP is caused by the invasion of the lower respiratory tract and lung parenchyma by microorganisms. Intubation compromises the integrity of the larynx and of the entire respiratory tree down to the alveoli, which can lead to pneumonia.

Symptoms

The symptoms of VAP include fever, low body temperature, purulent sputum, and hypoxemia (decreasing amount of oxygen in the blood). Other symptoms may include tachypnea, tachycardia, and changes in blood pressure.

Diagnosis

The diagnosis of VAP varies from one clinical setting to another but generally includes the presence of a new or progressive infiltrate on a chest X-ray, plus two or more clinical findings such as fever, low body temperature, purulent sputum, leukocytosis, and decline in oxygen status.

Treatment

The treatment of VAP includes the use of antibiotics. The choice of antibiotic will depend on the identity of the causative organism and its antibiotic susceptibility pattern. In addition to antibiotics, supportive measures such as oxygen, physiotherapy, and in some cases, surgery may be required.

Prevention

Prevention of VAP involves strategies to reduce the risk of aspiration, to prevent colonization of the aerodigestive tract, to prevent the spread of microorganisms, and to enhance host defenses.

See also

• Hospital-acquired pneumonia
• Pneumonia
• Mechanical ventilation
• Intensive care unit