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Medicina Intensiva
Print version ISSN 0210-5691
Abstract
DIAZ, E.; LORENTE, L.; VALLES, J. and RELLO, J.. Mechanical ventilation associated pneumonia. Med. Intensiva [online]. 2010, vol.34, n.5, pp.318-324. ISSN 0210-5691.
The second most important infectious complication in hospitalized patients is pneumonia, this occupying the first place in the Intensive Care Units (ICU). Approximately 80% of the episodes of nosocomial pneumonia occur in patients with an artificial air way, which is called ventilation-associated pneumonia (VAP). VAP is the most frequent cause of mortality among nosocomial infections in the ICU, mainly if they are caused by Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA). It also increases days of mechanical ventilation and length of stay in the ICU and hospital. In spite of the available diagnostic procedures, the diagnosis of VAP continues to be a clinical one. The presence of X-ray infiltrates and purulent endotracheal secretions are the essential conditions for the diagnosis. We should also evaluate the patients condition and the risk factors for difficult-to-treat pathogens. If the VAP is early and there are no risk factors, most of the empiricanti biotic strategies will provide correctc overage of the flora found. However, if the diagnos is of VAP is made in a patient who has been receiving mechanical ventilation for more than one week, underantibioticuse, with risk factors for multirresistant pathogens, we should in dividualize the empiricanti biotic treatment.
Keywords : Ventilator-associated pneumonia; Therapy; Trachobronchitis.