Diagnosis of ventilator associated pneumonia: Is there a simple solution?

Abstract

Over the last fifty years, mechanical ventilation has undoubtedly represented an advance in the treatment of respiratory insufficiency. However, nosocomial pneumonia has emerged as a leading complication of ventilation increasing morbidity, mortality and health care costs. Ventilator associated pneumonia (VAP) has been found to have varying rates in different studies based on the population studied and the type of diagnostic techniques used. While the incidence of VAP in children, according to the data from hospitals enrolled in the National Care and Safety Network, has been found to be as low as 2.3 per 1000 ventilator days in pediatric medical ICUs in the United States, VAP continues to be the second most common health care associated infection even in developed countries [1]. Two studies from India have shown contrastingly high VAP rates of 32.5% and 20% in children ventilated in Pediatric Intensive Care Units (PICU) [2,3]. In a recently published study from a tertiary care center in north india, the incidence of VAP was reported as 17.5/100 patients [4].