Intensive Care Medicine· 2020Q1· Review
Ventilator-associated pneumonia in adults: a narrative review
- 1,026citations
- Q1SCImago
- 2020year
Short summary
Ventilator-associated pneumonia (VAP) is a common ICU infection, occurring in 5-40% of patients, leading to longer mechanical ventilation, ICU stays, and ~10% attributable mortality.
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Key points
- VAP is a common ICU infection with incidence rates varying from 5% to 40%.
- VAP is linked to prolonged mechanical ventilation, extended ICU stays, and an estimated 10% attributable mortality.
- Microbiological confirmation is recommended, but the choice of sampling method is controversial.
- Prevention strategies include minimizing ventilation exposure and early liberation, with bundled approaches showing promise.
- Standard treatment duration for VAP is typically 7 days, with de-escalation based on culture results.
AI-generated from the title and abstract; the full text is not read.
Abstract
Ventilator-associated pneumonia (VAP) is one of the most frequent ICU-acquired infections. Reported incidences vary widely from 5 to 40% depending on the setting and diagnostic criteria. VAP is associated with prolonged duration of mechanical ventilation and ICU stay. The estimated attributable mortality of VAP is around 10%, with higher mortality rates in surgical ICU patients and in patients with mid-range severity scores at admission. Microbiological confirmation of infection is strongly encouraged. Which sampling method to use is still a matter of controversy. Emerging microbiological tools will likely modify our routine approach to diagnosing and treating VAP in the next future. Prevention of VAP is based on minimizing the exposure to mechanical ventilation and encouraging early liberation. Bundles that combine multiple prevention strategies may improve outcomes, but large randomized trials are needed to confirm this. Treatment should be limited to 7 days in the vast majority of the cases. Patients should be reassessed daily to confirm ongoing suspicion of disease, antibiotics should be narrowed as soon as antibiotic susceptibility results are available, and clinicians should consider stopping antibiotics if cultures are negative.
The authors' abstract, as published at the source. Intensive Care Medicine, 2020 · DOI ↗
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Field: Critical Care and Intensive Care Medicine
Critical Care and Intensive Care MedicineMedicine