ABSTRACT
Ventilator-associated pneumonia (VAP), which, by definition, has its onset at least 48 hours after intubation and the initiation of mechanical ventilation, is the most common nosocomial infection in ventilated patients. The presence of VAP is signaled by clinical observations including fever, tachypnea, increased purulent secretions, and changes in ventilator mechanics including reduced tidal volumes or increased pressures. Reducing the enormous burden of VAP requires diagnostic vigilance, prompt therapeutic action, and systemwide, evidence-based prevention measures. The choice of diagnostic methods for VAP holds significant consequences for the scope and duration of antibiotic therapy, the development of antimicrobial resistance and antibiotic-associated complications, and the costs of health care. With the high mortality rates associated with VAP, diagnostic measures, source control, and resuscitation should be initiated promptly. Given the impact of VAP on individual patients and the health care systems, many studies have explored strategies to prevent VAP.
