Ventilator-associated pneumonia (VAP) is one of the most frequent hospital-acquired infections occurring in intubated
patients. Because VAP is associated with higher mortality, morbidity and healthcare costs, there is a need to solicit further
research for effective preventive measures. VAP has been proposed as an indicator of quality of care. Clinical diagnosis
has been criticized to have poor accuracy and reliability. Thus, the Centers for Disease Control and Prevention has
introduced a new definition based upon objective and recordable data.
The principal determinant of VAP development is the presence of the endotracheal tube (ETT). Contaminated
oropharyngeal secretions pool over the ETT cuff and subsequently leak down to the lungs through a hydrostatic gradient.
Lastly, biofilm develops on the inner ETT surface and acts as a reservoir for microorganism inoculum to the lungs. New
preventive strategies are focused on the improvement of secretions drainage and prevention of bacterial colonization.
The influence of gravity on mucus flow and body positioning can facilitate the clearance of distal airways, with
decreased colonization of the respiratory tract. A different approach proposes ETT modifications to limit the leakage of
Real Time Impact Factor:
Author Name: Kundan Mittal,
URL: View PDF
Keywords: Ventilator, Pneumonia, Endotracheal Tube (ETT)