Abstract
The need for mechanical ventilation (MV) has paralleled the growth of the ICU for an ageing population with multiple disease entities, particularly those associated with pulmonary diseases. As the process of ventilation has improved, the etiology of ventilator Associated Pneumonia (VAP) has moved from the instrumentation to the colonization of the patient, focusing most recently on the link of normal oral flora as the initial, catalyzing insult in patients at risk for pneumonia through a biofilm in the lumen of the endotracheal tube (ETT).
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