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Intensive Care Medicine
Published in: Intensive Care Medicine 5/2020

01-05-2020 | Bronchoscopy | Narrative Review

Ventilator-associated pneumonia in adults: a narrative review

Authors: Laurent Papazian, Michael Klompas, Charles-Edouard Luyt

Published in: Intensive Care Medicine | Issue 5/2020

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Abstract

Ventilator-associated pneumonia (VAP) is one of the most frequent ICU-acquired infections. Reported incidences vary widely from 5 to 40% depending on the setting and diagnostic criteria. VAP is associated with prolonged duration of mechanical ventilation and ICU stay. The estimated attributable mortality of VAP is around 10%, with higher mortality rates in surgical ICU patients and in patients with mid-range severity scores at admission. Microbiological confirmation of infection is strongly encouraged. Which sampling method to use is still a matter of controversy. Emerging microbiological tools will likely modify our routine approach to diagnosing and treating VAP in the next future. Prevention of VAP is based on minimizing the exposure to mechanical ventilation and encouraging early liberation. Bundles that combine multiple prevention strategies may improve outcomes, but large randomized trials are needed to confirm this. Treatment should be limited to 7 days in the vast majority of the cases. Patients should be reassessed daily to confirm ongoing suspicion of disease, antibiotics should be narrowed as soon as antibiotic susceptibility results are available, and clinicians should consider stopping antibiotics if cultures are negative.
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Metadata
Title
Ventilator-associated pneumonia in adults: a narrative review
Authors
Laurent Papazian
Michael Klompas
Charles-Edouard Luyt
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 5/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-020-05980-0

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