Ventilator Associated Pneumonia in Adult Patients Preventive Measures: A Review of the Recent Advances

Abstract

Ventilator Associated Pneumonia (VAP) is the most commonly acquired ICU infection worldwide affecting nearly 10-30% of ventilated patients and accounting for nearly 25% of all types of ICU infections. VAP has been associated with increased morbidity, mortality, duration of ICU stay, duration of mechanical ventilation and nearly 50% of the ICU antibiotic prescription. After understanding the pathogenesis of VAP, various preventive measures have been tried by various authors. The currently accepted preventive measures are being used in most centres as the VAP prevention bundle. This includes: elevation of the head of the bed between 30°and 45°, daily sedation interruption and assessment of readiness to extubate, daily oral care with Chlorhexidine, peptic ulcer disease prophylaxis and deep vein thrombosis prophylaxis. In the current manuscript, we will be discussing the available preventive measures. Other measures which have been shown to be effective include selective oropharyngeal and digestive tract decontamination, use of antimicrobial coated ET tubes. However, more studies need to be done to see if these can be included in the VAP prevention bundle.