title: Ventilator Associated Pneumonia in Children.
abstract: Ventilator associated pneumonia (VAP) is a common complication in mechanically ventilated children and adults. There remains much controversy in the literature over the definition, treatment and prevention of VAP. The incidence of VAP is variable, depending on the definition used and can effect up to 12% of ventilated children. For the prevention and reduction of the incidence of VAP, ventilation care bundles are suggested, which include vigorous hand hygiene, head elevation and use of non-invasive ventilation strategies. Diagnosis is mainly based on the clinical presentation with a lung infection occurring after 48hours of mechanical ventilation requiring a change in ventilator settings (mainly increased oxygen requirement, a positive culture of a specimen taken preferentially using a sterile sampling technique either using a bronchoscope or a blind lavage of the airways). A new infiltrate on a chest X ray supports the diagnosis of VAP. For the treatment of VAP, initial broad-spectrum antibiotics should be used followed by a specific antibiotic therapy with a narrow target once the bacterium is confirmed.
authors.affiliation: Paediatric Critical Care Research Group, Lady Cilento Children's Hospital, South Brisbane QLD.
authors.forename: Ivy
authors.initials: I
authors.lastname: Chang
authors.affiliation: Paediatric Critical Care Research Group, Lady Cilento Children's Hospital, South Brisbane QLD. Electronic address: a.schibler@uq.edu.au.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schibler
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D014943:Global Health; D006801:Humans; D015994:Incidence; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D012121:Respiration, Artificial / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infection Control; Mechanical Ventilation; Paediatric Intensive Care; Ventilator Induced Lung Injury