Ventilator-associated pneumonia in adults: a narrative review.

Intensive Care Medicine
Laurent PapazianCharles-Edouard Luyt

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 n...Continue Reading

Associated Clinical Trials

References

Apr 1, 1996·Anesthesiology·N FàbregasR Rodriguez-Roisin
Jul 1, 1996·American Journal of Respiratory and Critical Care Medicine·L PapazianF Gouin
May 14, 1998·Anesthesiology·L PapazianF Gouin
Sep 12, 1998·Annals of Internal Medicine·D J CookC Brun-Buisson
Dec 1, 1999·Critical Care Medicine·M LabenneP Hubert
Dec 12, 2002·Chest·Jordi RelloUNKNOWN VAP Outcomes Scientific Advisory Group
Nov 20, 2003·JAMA : the Journal of the American Medical Association·Jean ChastreUNKNOWN PneumA Trial Group
Jan 30, 2004·The New England Journal of Medicine·Sébastien GibotPierre-Edouard Bollaert
Feb 9, 2005·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN Infectious Diseases Society of America
Oct 19, 2006·Journal of Microbiological Methods·L C ThomasJ Iredell
Jan 20, 2007·American Journal of Respiratory and Critical Care Medicine·Charles-Edouard LuytJean Chastre
Apr 12, 2007·JAMA : the Journal of the American Medical Association·Michael Klompas
Apr 19, 2008·Intensive Care Medicine·Charles-Edouard LuytJean Chastre
Jun 17, 2008·Critical Care Medicine·Lucy B PalmerPaul Richman
Jun 5, 2010·American Journal of Respiratory and Critical Care Medicine·Jean-Claude LacheradeSylvie Bastuji-Garin
Aug 10, 2010·American Journal of Respiratory and Critical Care Medicine·Mariano EsperattiAntoni Torres
Apr 9, 2011·American Journal of Respiratory and Critical Care Medicine·Qin LuUNKNOWN Nebulized Antibiotics Study Group
Jul 19, 2011·Critical Care Medicine·Wilhelmina G MelsenMarc J M Bonten
Jul 19, 2011·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Marie-Soleil DelisleDaren K Heyland
Aug 20, 2011·American Journal of Respiratory and Critical Care Medicine·Maarten BekaertUNKNOWN Outcomerea Study Group
Sep 17, 2011·American Journal of Respiratory and Critical Care Medicine·Doo Ryeon ChungUNKNOWN Asian Network for Surveillance of Resistant Pathogens Study Group
Sep 29, 2011·American Journal of Infection Control·Michael Klompas
Apr 21, 2012·American Journal of Respiratory and Critical Care Medicine·Stijn I BlotUNKNOWN AspICU Study Investigators
Apr 25, 2012·Critical Care : the Official Journal of the Critical Care Forum·Jean-Marie ForelLaurent Papazian
Jun 14, 2012·JAMA : the Journal of the American Medical Association·Frank M BrunkhorstUNKNOWN German Study Group Competence Network Sepsis (SepNet)
Jan 17, 2013·JAMA : the Journal of the American Medical Association·Jean ReignierUNKNOWN Clinical Research in Intensive Care and Sepsis (CRICS) Group
Jan 29, 2013·The Lancet Infectious Diseases·Nick DanemanUNKNOWN SuDDICU Canadian Study Group
Mar 30, 2013·American Journal of Infection Control·Margaret A DudeckJonathan R Edwards
Apr 13, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Carmen PeñaUNKNOWN Spanish Network for Research in Infectious Diseases (REIPI)

❮ Previous
Next ❯

Citations

Aug 14, 2020·Clinical Oral Investigations·Niina RautaporrasJohanna Snäll
Jul 1, 2020·Antimicrobial Agents and Chemotherapy·Mohammad H Al-ShaerCharles A Peloquin
Sep 3, 2020·BMC Infectious Diseases·Ehsan SharifipourSamad Ej Golzari
Nov 12, 2020·Intensive Care Medicine·Charles-Edouard LuytJean-François Timsit
Dec 4, 2020·Expert Review of Anti-infective Therapy·Marios KarvouniarisGaryphallia Poulakou
Aug 3, 2020·Current Opinion in Critical Care·Despoina KoulentiParaskevi C Fragkou
Jan 12, 2021·Annals of Intensive Care·Thècle DegrooteUNKNOWN MicroCOPD study group
Oct 17, 2020·Journal of Breath Research·Michael D DavisAlison J Montpetit
Feb 7, 2021·Journal of Clinical Medicine·Daniele Roberto GiacobbeMatteo Bassetti
Feb 22, 2021·Indian Journal of Medical Microbiology·Purva MathurRajesh Malhotra
Apr 2, 2021·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Jara R de la CourtRogier P Schade
Apr 23, 2021·Nursing in Critical Care·Canan Kaş Güner, Sevinç Kutlutürkan
May 1, 2021·Annals of the American Thoracic Society·Owen R Albin, Andrew J Admon
Apr 16, 2021·Chest·Giacomo GrasselliAlessandra Bandera
Jun 5, 2021·Annals of Biomedical Engineering·Xiaofeng DaiMeng Ning
May 27, 2021·Critical Care : the Official Journal of the Critical Care Forum·Saad NseirUNKNOWN coVAPid study group
Jun 3, 2021·International Journal of Environmental Research and Public Health·Shu-Farn TeyWen-Shiann Wu
Jun 10, 2021·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Qing MiaoBijie Hu
Jun 5, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·François CamélénaBéatrice Berçot
Aug 10, 2021·Chest·Nicolas MarjanovicUNKNOWN AGATE Study Group
Sep 1, 2021·Critical Care : the Official Journal of the Critical Care Forum·Giacomo GrasselliGaetano Florio
Jul 30, 2021·Current Opinion in Critical Care·Pedro PovoaSaad Nseir
Sep 4, 2021·Materials Science & Engineering. C, Materials for Biological Applications·Anna DonnadioValeria Ambrogi
Sep 30, 2021·Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace·Shikha JainSoumya Sarkar
Oct 30, 2021·Journal of Basic and Clinical Physiology and Pharmacology·Sameer A AlkubatiMahmoud Al-Areefi
Nov 4, 2021·Anesthesiology·Michael MazzeffiClare Rock

❮ Previous
Next ❯

Methods Mentioned

BETA
bronchoalveolar lavage
X-ray
bronchoalveolar
biopsies
PCR
sedation

Clinical Trials Mentioned

NCT00851435

Software Mentioned

SAATELITE

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.