TY  - CHAP
M1  - Book, Section
TI  - Chapter 46. Pneumonia in the Ventilator-Dependent Patient
A1  - Chastre, Jean E.
A1  - Luyt, Charles-Edouard
A1  - Fagon, Jean-Yves
A2  - Tobin, Martin J.
PY  - 2013
T2  - Principles and Practice of Mechanical Ventilation, 3e
AB  - Ventilator-associated  pneumonia  (VAP)  is  the  most  frequent  intensive  care  unit  (ICU)-acquired  infection  among  patients  receiving  mechanical  ventilation.1  In  contrast  to  infections  of  other  frequently  involved  organs  (e.g.,  urinary  tract  and  skin),  for  which  mortality  is  low,  ranging  from  1%  to  4%,  the  mortality  rate  for  VAP,  defined  as  pneumonia  occurring  more  than  48  hours  after  endotracheal  intubation  and  initiation  of  mechanical  ventilation,  ranges  from  20%  to  50%  and  can  even  be  higher  in  some  specific  settings  or  when  lung  infection  is  caused  by  high-risk  pathogens.1–3  Although  the  attributable  mortality  rate  for  VAP  is  still  debated,  it  has  been  shown  that  these  infections  prolong  both  the  duration  of  ventilation  and  the  duration  of  ICU  stay.1,2  Approximately  50%  of  all  antibiotics  prescribed  in  an  ICU  are  administered  for  respiratory  tract  infections.4  Because  several  studies  have  shown  that  appropriate  antimicrobial  treatment  of  patients  with  VAP  significantly  improves  outcome,  more  rapid  identification  of  infected  patients  and  accurate  selection  of  antimicrobial  agents  represent  important  clinical  goals.2  Consensus,  however,  on  appropriate  diagnostic,  therapeutic,  and  preventive  strategies  for  VAP  has  yet  to  be  reached.  In  this  chapter,  we  summarize  published  studies  on  epidemiology,  diagnosis,  treatment,  and  prevention  of  nosocomial  pulmonary  infection  in  critically  ill  patients  mechanically  ventilated  in  the  ICU,  and  present  our  experience  with  this  infection.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessmedicine.mhmedical.com/content.aspx?aid=57076375
ER  -