Ventilator-Associated Pneumonia

Robert M. Owen,Kevin W. Chung

Advanced Anesthesia Review(2023)

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摘要
Abstract Ventilator-associated pneumonia (VAP) is a serious nosocomial infection that is often encountered in the critical care setting. While there is no firm consensus on the “gold standard” of diagnosis; it is most broadly accepted to be a pneumonia that occurs more than 48 hours after endotracheal intubation. VAP can result in prolonged hospital stays, increased resource utilization, and significant morbidity and mortality. As VAP occurs in patients who already have critical illness, progression to acute respiratory distress syndrome (ARDS), empyema, sepsis, and septic shock are common. Several strategies have been implemented, often in the form of ventilator “bundles,” to prevent VAP as well as other ventilator-associated events. The most common causative organisms for VAP include Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae members. Multidrug-resistant (MDR) pathogens are of increasing concern. Systemic antibiotics serve as the mainstay of treatment. Antibiotic choice should be driven not only from a desire to cover both methicillin-resistant S. aureus (MRSA) and Pseudomonas aeruginosa, but also by the institution’s local patterns of microbial flora and resistance.
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关键词
pneumonia,ventilator-associated
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