Article metrics

  • citations in SCindeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[=>]
  • visits in previous 30 days:19
  • full-text downloads in 30 days:17
article: 2 from 6  
Back back to result list
Serbian Journal of Anesthesia and Intensive Therapy
2014, vol. 36, iss. 1-2, pp. 109-116
article language: Serbian
document type: Review Paper
Ventilator associated pneumonia
aMedicinski fakultet, Novi Sad + Klinički centar Vojvodine, Novi Sad
bMedicinski fakultet, Beograd + Centar za anesteziologiju i reanimatologiju Kliničkog centra Srbije, Beograd
cKlinički centar Vojvodine, Novi Sad
dClinical Centre



Pneumonia associated with ventilator support patients (VAP) is a type of nosocomial infection and is defined as pneumonia occurred 48 hours after intubation of patients and initiation of mechanical ventilation. The incidence is 8-28% intubated patients and is associated with a high mortality rate of 33-50%. The causes are usually bacteria, depending on the time of onset is caused by sensitive or resistant strains of bacteria. The primary way of maturities of pathogens into the trachea through a tube - aspiration, or diffusion of bacteria around the endotracheal tube coffee. Accompanied by a high mortality rate, increased cost and length of treatment, and much attention is given to non-pharmacological and pharmacological measures preventing its occurrence. A crucial role is early diagnosis that will affect the choice of antibiotics. Diagnosis is based on clinical presentation, radiographic findings and microbiological results. The therapy is conducted one antibiotic - monotherapy or a combination of different antibiotics. The choice of antibiotics depends on the time of onset of pneumonia since the beginning of mechanical ventilation and the presence of risk factors for infections caused by multiresistant strains of bacteria. The optimal antibiotic therapy is the key to successful treatment of ventilator pneumonia joint.



*** (2010) Your guide to the Standardized Infection Ratio (SIR). October,
Adair, C.G., Gorman, S.P., Feron, B.M., Byers, L.M., Jones, D.S., Goldsmith, C.E., Moore, J.E., Kerr, J.R., Curran, M.D., Hogg, G. (1999) Implications of endotracheal tube biofilm for ventilator-associated pneumonia. Intensive care medicine, 25(10): 1072-6
American Thoracic Society (2005) Guidelines for the management of adults with hospitalacquired, ventilatorassociated, and healthcare-associated pneumonia. Am J Respir Crit Care Med, 171: 388-416
Cameron, J.L., Reynolds, J., Zuidema, G.D. (1973) Aspiration in patients with tracheostomies. Surgery, gynecology & obstetrics, 136(1): 68-70
Centers for Disease Control and Prevention (2003) Guidelines for preventing health-care-associated pneumonia, 2003: Recommendations of CDC and the healthcare infection control 4. MMWR, Practices Advisory Committee, 53(No. RR-3), 2003guidelines.pdf
Chastre, J., Wolff, M., Fagon, J.Y. (2003) Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA, 290: 2588-98
Chastre, J., Fagon, J. (2002) Ventilator-associated pneumonia. Am J Respir Crit Care Med, 165(7): 867-903
Cook, D., de Jonghe, B., Brochard, L., Brun-Buisson, C. (1998) Influence of airway management on ventilator-associated pneumonia: evidence from randomized trials. JAMA, 279(10): 781-7
Cook, D.J., Walter, S.D., Cook, R.J., Griffith, L.E., Guyatt, G.H., Leasa, D., Jaeschke, R.Z., Brun-Buisson, C. (1998) Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Annals of internal medicine, 129(6): 433-40
Craven, D.E. (2000) Epidemiology of Ventilator-Associated Pneumonia. Chest, 117(4): 186S-187S
Craven, D.E., Steger, K.A. (1995) Epidemiology of Nosocomial Pneumonia. Chest, 108(2): 1S-16S
du Moulin, G.C., Paterson, D.G., Hedley-Whyte, J., Lisbon, A. (1982) Aspiration of gastric bacteria in antacid-treated patients: a frequent cause of postoperative colonisation of the airway. Lancet, 1(8266): 242-5
Dudeck, M.A., Horan, T.C., Peterson, K.D. National healthcare safety network (NHSN) report: Data summary for 2011, device-associated module. http://
Edwards, J.R., Peterson, K.D., Mu, Y., Banerjee, S., Allen-Bridson, K., Morrell, G., Dudeck, M.A., Pollock, D.A., Horan, T.C. (2009) National Healthcare Safety Network (NHSN) report: Data summary for 2006 through 2008, issued December 2009. American Journal of Infection Control, 37(10): 783-805
Fowler, R.A., Flavin, K.E., Barr, J., Weinacker, A.B., Parsonnet, J., Gould, M.K. (2003) Variability in antibiotic prescribing patterns and outcomes in patients with clinically suspected ventilator-associated pneumonia. Chest, 123(3): 835-44
Heyland, D., Dodek, P., Muscedere, J., Day, A., Cook, D. (2006) For the Canadian Critical Care Trials Group: A multicentre trial of invasive diagnostic techniques for ventilator associated pneumonia. New Eng J Med, 355: 2619-30
Hunter, J., Corry, P. (2002) Ventilator-associated pneumonia. BJA, 2(5), str. 148-150
Inglis, T.J., Millar, M.R., Jones, J.G., Robinson, D.A. (1989) Tracheal tube biofilm as a source of bacterial colonization of the lung. Journal of clinical microbiology, 27(9): 2014-8
Iregui, M., Ward, S., Sherman, G., Fraser, V.J., Kollef, M.H. (2002) Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia. Chest, 122(1): 262-8
Klevens, R.M., Edward, J.R., Richards, C.L. (2007) Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Reports, 122, 160-6,
Koenig, S.M., Truwit, J.D. (2006) Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention. Clinical Microbiology Reviews, 19(4): 637-657
Kollef, M.H. (1999) The Prevention of Ventilator-Associated Pneumonia. New England Journal of Medicine, 340(8): 627-634
Langer, M., Mosconi, P., Cigada, M., Mandelli, M. (1989) Long-term respiratory support and risk of pneumonia in critically ill patients. Intensive Care Unit Group of Infection Control. American review of respiratory disease, 140(2): 302-5
Mayhall, C. G. (2001) Ventilator-Associated Pneumonia or Not? Contemporary Diagnosis. Emerging Infectious Diseases, 7(2): 200-204
Mehta, R., Groth, M. (2000) Invasive or non-invasive management of suspected ventilator-associated pneumonia?, And old controversy revisited. Clin Pulm Med, 7, 277-9
Morrow, L.E., Kollef, M.H., Casale, T.B. (2010) Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial. American Journal of Respiratory and Critical Care Medicine, 182(8): 1058-64
Muscedere, J., Dodek, P., Keenan, S., Fowler, R., Cook, D., Heyland, D. (2008) Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: prevention. Journal of critical care, 23(1): 126-37
Nseir, S., di Pompeo, C., Pronnier, P., Beague, S., Onimus, T., Saulnier, F., Grandbastien, B., Mathieu, D., Delvallez-Roussel, M., Durocher, A. (2002) Nosocomial tracheobronchitis in mechanically ventilated patients: incidence, aetiology and outcome. European respiratory journal, 20(6): 1483-9
Paladino, J.A. (1995) Pharmacoeconomic comparison of sequential IV/oral ciprofloxacin versus ceftazidime in the treatment of nosocomial pneumonia. Canadian journal of hospital pharmacy, 48(5): 276-83
Pugin, J., Auckenthaler, R., Mili, N., Janssens, J.P., Lew, P.D., Suter, P.M. (1991) Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic 'blind' bronchoalveolar lavage fluid. American review of respiratory disease, 143(5 Pt 1): 1121-9
R. Hubmayr (2002) Statement of the 4th International Consensus Conference in Critical Care on ICU-Acquired Pneumonia - Chicago, Illinois, May 2002. Intensive Care Medicine, 28(11): 1521-1536
Rello, J., Paiva, J.A., Baraibar, J., Barcenilla, F., Bodi, M., Castander, D., Correa, H., Diaz, E., Garnacho, J., Llorio, M. (2001) International Conference for the Development of Consensus on the Diagnosis and Treatment of Ventilator-associated Pneumonia. Chest, 120(3): 955-70
Rello, J., Ollendorf, D.A., Oster, G., Vera-Llonch, M., Bellm, L., Redman, R., Kollef, M.H. (2002) Epidemiology and Outcomes of Ventilator-Associated Pneumonia in a Large US Database. Chest, 122(6): 2115-2121
Stolz, D., Smyrnios, N., Eggimann, P., Pargger, H., Thakkar, N., Siegemund, M., Marsch, S., Azzola, A., Rakic, J., Mueller, B. (2009) Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia: a randomised study. European respiratory journal, 34(6): 1364-75
Vallés, J., Artigas, A., Rello, J., Bonsoms, N., Fontanals, D., Blanch, L., Fernández, R., Baigorri, F., Mestre, J. (1995) Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia. Annals of internal medicine, 122(3): 179-86
Warren, D.K., Shukla, S.J., Olsen, M.A., Kollef, M.H., Hollenbeak, C.S., Cox, M.J., Cohen, M.M., Fraser, V.J. (2003) Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Critical Care Medicine, 31(5): 1312-1317