Current Infectious Disease Reports

, Volume 13, Issue 3, pp 287–295 | Cite as

Ventilator-Associated Pneumonia: Update on Etiology, Prevention, and Management

Article

Abstract

Ventilator-associated pneumonia (VAP) remains one of the most important nosocomial infections in the intensive care unit and has been the focus of much recent research. New evidence on VAP preventive measures includes evidence for the efficacy of changes in endotracheal tube cuff design and materials, drainage of subglottic secretions, saline instillation prior to tracheal suctioning, patient positioning, oral decontamination, aerosolized antibiotics, and probiotic use. In the absence of a clinical reference standard, the diagnosis of VAP remains problematic. Although extensive research on invasive sampling techniques for microbiological confirmation has been conducted, current evidence suggests that endotracheal aspirates are equivalent. Promising new diagnostic methods include non–culture-based microbiological techniques and biomarkers. The treatment of VAP continues to evolve. Shorter antibiotic treatment duration is effective. As well, novel methods of antimicrobial delivery to maximize antibiotic effectiveness and the use of inflammatory biomarkers to guide duration of antibiotic therapy show promise.

Keywords

Ventilator-associated pneumonia Nosocomial infections Etiology Prevention Diagnosis Management Intensive care unit 

Notes

Disclosure

Conflicts of interest: O. Rewa—none; J. Muscedere—unrestricted research grant for investigator-initiated trial, Covidien.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of MedicineQueen’s UniversityKingstonCanada
  2. 2.Critical Care ProgramQueen’s UniversityKingstonCanada
  3. 3.Clinical Evaluation Research UnitKingston General HospitalKingstonCanada
  4. 4.Kingston General HospitalKingstonCanada

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