Ventilator-Associated Pneumonia (VAP)

Ventilator-Associated Pneumonia

Ventilator-associated pneumonia (VAP) is a severe form of pneumonia that is caused by an infection acquired while the patient is receiving ventilation therapy, usually in a hospital setting. VAP often leads to a prolonged hospital stay, increased costs for care, and a substantially higher chance of death when compared to non-ventilated patients.

VAP is one of the most serious and costly of healthcare-associated infections, occurring in up to 27% of intensive care unit (ICU) patients on mechanical ventilation. The mortality rate of VAP ranges from 10-50%, depending on the severity of the patient’s illness at the time of diagnosis. It has been estimated that healthcare-associated infections like VAP cost hospitals an extra billion dollars each year.

Risk Factors

Risk factors for developing VAP include:

  • Being intubated (having a tube inserted through the mouth or nose) for more than 48 hours
  • Being critically ill
  • Having other severe illnesses
  • Having a weakened immune system
  • Using certain sedatives or analgesics to keep the patient sedated while intubated

Preventive Strategies

The best way to prevent VAP is to keep the patient’s airway clean and free from infection-causing bacteria. Certain strategies can be used to reduce the risk of VAP, such as:

  • Hand hygiene
  • Proper maintenance of the ventilator
  • Regular assessment of the patient’s breathing pattern and ventilator settings
  • Elevating the head of the bed to reduce the pooling of secretions
  • Administering antibiotics when necessary
  • Regularly changing the patient’s tube and suctioning devices

Diagnosis and Treatment

The diagnosis of VAP is based on several criteria, including chest X-ray results, laboratory tests, and cultures of the airway. Treatment usually consists of antibiotics and supportive care to keep the patient comfortable.

For patients who don’t respond to antibiotics or who develop complications, more aggressive treatments such as bronchoscopy or removal of the breathing tube may be required.