• The American surgeon · May 2007

    Review

    Strategies in the prevention and management of ventilator-associated pneumonia.

    • Fredric M Pieracci and Philip S Barie.
    • Department of Surgery , Weill Medical College, Cornell University, New York, New York, USA.
    • Am Surg. 2007 May 1;73(5):419-32.

    AbstractVentilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in the intensive care unit. Prevention of VAP is possible through the use of several evidence-based strategies intended to minimize intubation, the duration of mechanical ventilation, and the risk of aspiration of oropharyngeal pathogens. Current data favor the quantitative analysis of lower respiratory tract cultures for the diagnosis of VAP, accompanied by the initiation of broad-spectrum empiric antimicrobial therapy based on patient risk factors for infection with multi-drug-resistant pathogens and data from unit-specific antibiograms. Eventual choice of antibiotic and duration of therapy are selected based on culture results and patient stability, with an emphasis on minimization of unnecessary antibiotic use.

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