ABSTRACT
Modern use of positive pressure ventilation originated in the early 1950s, when it was recognized that supportive care with endotracheal tubes and manual ventilation with an inflated rubber bag could dramatically reduce the mortality of polio-induced respiratory failure. Ventilator-associated pneumonia (VAP) complicate the intensive care unit stays of up to 10% of mechanically ventilated patients, resulting in prolonged stays, increased mortality, as well as approximately $40,000 of added healthcare costs per patient. An understanding of the pathophysiology of VAPs has been paramount to the development of prevention strategies. The mutually inclusive nature of many VAP prevention strategies supports the bundling of several approaches together into quality improvement initiatives designed to reduce VAP rates further than any one intervention alone. Successful VAP treatment relies on prompt diagnosis with empiric antibiotic therapy targeting the most likely pathogens, followed by appropriate tailoring of antibiotics to minimize the risk of antimicrobial resistance and antibiotic-associated complications.
