Ventilator-associated Bacterial Pneumonia caused by susceptible Gram-negative microorganisms
Ventilator-Associated Bacterial Pneumonia (VAP)
Ventilator- associated bacterial pneumonia (VAP) is a type of pneumonia caused by a susceptible gram-negative microorganisms that can develop in individuals who receive mechanical ventilation for more than 48 hours.
Identifying Risk Factors
Risk factors for VAP include immobility, an existing lung infection, and mechanical ventilation, specifically when endotracheal cuffs are employed, and in addition to the introduction of contaminated nebulizer treatments.
Symptoms of VAP
Most common symptoms of VAP are fever, increased breathing rate, and low oxygen levels that are not responding to oxygen therapy. These symptoms are usually accompanied by an infection in the lower respiratory tract that can also cause a cough and an increase in white blood cells.
Diagnosis
Diagnosis of VAP is based on clinical and laboratory assessment. PCP is the most common organism involved in VAP, followed by Klebsiella, Pseudomonas, and Enterobacter. Chest X-rays and sputum cultures can help to identify the microorganism and the severity of the infection.
Preventive Measures
The following preventive measures can reduce the risk of VAP:
- Raising the head of the patient's bed to 30 degrees or higher.
- Keeping patients on their backs and using antibiotic-coated endotracheal cuffs.
- Performing oral care on a regular basis.
- Avoiding unnecessary nebulizer treatments and suctioning of the patient's airway.
- Using nursing-led protocols for ventilator care.
- Using evidence-based strategies for antibiotic prophylaxis.
Treatment
Treatment of VAP typically involves administration of broad-spectrum antibiotics and aggressive respiratory and hemodynamic support to treat the underlying infection. The antibiotics usually used include third-generation cephalosporins, aminoglycosides, fluoroquinolones, and carbapenems. Excellent outcomes can be achieved by early diagnosis and aggressive treatment.