Ventilator associated pneumonia: perspectives on the burden of illness.

摘要: Objective: The objective of this narrative review is to summarize selected current concepts and clinical evidence regarding the burden illness VAP, including its epidemiology, diagnosis, attributable mortality risk factors.¶Data Sources & Selection: Studies were identified through MEDLINE, EMBASE, bibliographies primary articles personal files.¶Results: While cross sectional studies inform us about VAP prevalence, longitudinal cumulative conditional developing VAP. Reported rates are modulated by factors related case mix, causative micro-organisms, interventions that influence over time, definitions employed. Population-specific organism-specific needed avoid misleading benchmarking between different ICUs, minimize inappropriate between-study comparisons. Observational have shown invasive sampling techniques versus non-invasive approaches diagnose facilitates more targeted antibiotic treatment; however, diagnostic method on endpoints such as less clear. associated with approximately a 4 day increase in length ICU stay an 20–30 %. Fixed include underlying cardiorespiratory disease, neurologic injury trauma. Modifiable supine body position, witnessed aspiration, paralytic agents exposure. If modifiable tested randomized trials lower rates, semirecumbency positioning, these represent effective prevention strategies.¶Conclusions: Ventilator-associated pneumonia major morbid outcome among critically ill patients. evaluating treatment strategies needed.