This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (23)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Pneumonia  • Bacterial Infections  • Infectious Diseases, Other  • Critical Care/ Intensive Care Medicine  • Adult Critical Care  • Alert me on articles by topic

Richard Scott Morehead, MD; Simmy Jerry Pinto, MD

Arch Intern Med. 2000;160:1926-1936.

Ventilator-associated pneumonia is a common complication in intensive care units, occurring in 9% to 24% of patients intubated for longer than 48 hours. Because of this large disease burden and the resultant attributable morbidity and mortality, there is great interest in accurately diagnosing, treating, and preventing this complication. More severely ill patients tend to develop ventilator-associated pneumonia, and identified risk factors include prolonged mechanical ventilation, reintubation after failed extubation, and a few other clinical variables. The efficacy of diagnostic and preventive strategies is somewhat controversial. Diagnosis by invasive methods requires a considerable commitment of resources but can potentially reduce cost of care; however, mortality benefit from this approach has not been demonstrated. As such, in most institutions, ventilator-associated pneumonia is best diagnosed using traditional clinical criteria. Prompt administration of appropriate antibiotics seems to be the only intervention that alters outcome once the diagnosis is established. Several strategies seem to reduce pneumonia incidence; however, mortality and cost benefits have yet to be convincingly shown.

From the Division of Pulmonary and Critical Care Medicine, University of Kentucky School of Medicine, and the Department of Medicine, Veterans Affairs Medical Center, Lexington, Ky (Dr Morehead). Dr Pinto is in private practice in Orlando, Fla.

RELATED ARTICLE

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2000;160(13):2068-2069.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Enhancement of the endotoxin recognition pathway by ventilation with a large tidal volume in rabbits
Moriyama et al.
Am. J. Physiol. Lung Cell. Mol. Physiol. 2004;286:L1114-L1121.
ABSTRACT | FULL TEXT  

A Multisite Survey of Suctioning Techniques and Airway Management Practices
Sole et al.
Am J Crit Care 2003;12:220-230.
ABSTRACT | FULL TEXT  

Rapid Imipenem/Cilastatin Desensitization for Multidrug-Resistant Acinetobacter Pneumonia
Gorman et al.
The Annals of Pharmacotherapy 2003;37:513-516.
ABSTRACT | FULL TEXT  

Frequent Transmission of Enterococcal Strains between Mechanically Ventilated Patients Treated at an Intensive Care Unit
Lund et al.
J. Clin. Microbiol. 2002;40:2084-2088.
ABSTRACT | FULL TEXT