Relationship between microaspiration of gastric contents and ventilator-associated pneumonia

Aspiration of gastric contents is common in critically ill patients, and has been identified as a risk factor for ventilator-associated pneumonia (VAP). A prospective multicenter study, using pepsin as a marker of microaspiration of gastric content reported that 88.9% of the 360 included patients experienced at least one episode of microaspiration (1). However, in many patients this event is not followed by any negative impact on patient outcome.