Update in ventilator-associated pneumonia.
OBJECTIVE
Ventilator-associated pneumonia remains an important topic (or subject) in the care of the critically ill. Issues related to ventilator-associated pneumonia are now particularly acute given the continued increase in rates of antimicrobial resistance seen in intensive care units. This review examines the latest literature in this area, including promising approaches to infection prevention and recently developed guidelines to aid clinicians in limiting, identifying and treating ventilator-associated pneumonia.


RESULTS
Increasingly rigorous and robust studies have shown the enormous cost, morbidity and mortality of infections acquired in the intensive care unit in general and of ventilator-associated pneumonia in particular, and offered potential management options. Specific areas of promise include advances in means of diagnosis, such as appropriate use of bronchoscopy and inflammatory markers, and treatment methods, including short-course treatment regimens and the use of 'de-escalation' as a strategy for antibiotic prescribing.


CONCLUSIONS
Recent studies have started to illuminate the full magnitude of the impact of ventilator-associated pneumonia in the intensive care unit and suggest potential measures for intervention. Hopefully, additional work will aid in eventual development of effective preventive, diagnostic and therapeutic strategies that can reliably improve patient outcomes.
Jackson
William L
WL
Critical Care Medicine Service, Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20010, USA.
Shorr
Andrew F
AF
D017052:Hospital Mortality; D006801:Humans; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D012122:Ventilators, Mechanical / Q000009:adverse effects*