title: Ventilator-associated pneumonia in burn patients: a cause or consequence of critical illness?
abstract: Infectious complications are a constant threat to thermally injured patients during hospitalizations and are a predominant cause of death. Most of the infections that develop in burn patients are nosocomial and of a pulmonary etiology. The bacteria that cause ventilator associated pneumonia (VAP) take advantage of the fact that uniquely among intensive care unit patients endotracheal intubation allows them a 'free' passage to the sterile lower airways; however, the combination of severe thermal injury (systemic immunosuppression) and inhalation injury (local immunosuppression and tissue injury) create an ideal environment for development of VAP. Thus, strategies directed at preventing and treating VAP in burn patients must address not only rapid extubation and VAP prevention bundles known to work in other intensive care unit populations, but therapies directed to more rapid wound healing and restoration of pulmonary patency.
authors.affiliation: Department of Surgery, University of Texas Medical School, Houston, TX, USA. todd.f.huzar@uth.tmc.edu
authors.forename: Todd F
authors.initials: TF
authors.lastname: Huzar
authors.forename: James M
authors.initials: JM
authors.lastname: Cross
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002056:Burns / Q000150:complications / Q000628:therapy*; D016638:Critical Illness; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D012121:Respiration, Artificial / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D015208:Smoke Inhalation Injury / Q000150:complications / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents