Use of broad-spectrum antibiotics is also not recommended for the prevention of VAP because of increasing antibiotic resistance among subsequent hospital acquired infections.
Targeted antibiotic therapy with appropriate dose of appropriate antibiotic is the sensible thing to do.
Abstract Ventilator Associated Pneumonia (VAP) is pneumonia occurring in a patient within 48 hours or more after intubation with an endotracheal tube or tracheostomy tube and which was not present before.
Ventilator Associated Pneumonia (VAP) is defined as pneumonia occurring in a patient within 48 hours or more after intubation with an endotracheal tube or tracheostomy tube and which was not present before.
Diagnosis Despite the high incidence, diagnosis remains challenging because many conditions common to ICU patients like ARDS, sepsis, cardiac failure and lung atelectasis have similar clinical signs.
The ventilator circuit and the respiratory-therapy equipment may also contribute to the pathogenesis of VAP if they become contaminated with bacteria, which usually originate in the patient’s secretions. There is insufficient evidence to recommend any particular antibiotic regimen. Use of kinetic beds - a lack of robust evidence meant the Committee was unable to make recommendations for action on the use of kinetic beds. Care bundles - although the evidence supported the use of elements of care bundles; there was insufficient evidence to recommend a care bundle of any specific design.
Prevention: The National Institute of Clinical Excellence (NICE) in collaboration with National Patient Safety Agency (NPSA) is examining four technical patient safety solutions for the prevention of VAP and in the process of publishing guidelines. The Department of Health published the following ‘High impact intervention’ for ventilated patients in June 2007.
However, Specialist Advisers stated that UK intensive care specialists had particular concerns about the risk of infection with and the induction and/or selection of resistant, including multiresistant, microorganisms as a result of SDD.
Therefore the Committee recommended further research into SDD in a UK setting.The child’s age is important in making the diagnosis.Pneumonia in neonates younger than three weeks of age most often is caused by an infection obtained from the mother at birth.VAP increases length of ICU stay by 28% and each incidence of VAP is estimated to generate an increased cost of £6000- £22000.The NICE in collaboration with NPSA is examining four technical patient safety solutions for the prevention of VAP.The technical patient safety solutions for VAP in adults were published in August 2008.