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Prevention of ventilator-associated pneumonia or ventilator-associated complications: A worthy, yet challenging, goal*

Kollef, Marin H. MD

doi: 10.1097/CCM.0b013e318232e41d
Alternate Point of View Article

Ventilator-associated pneumonia is a difficult diagnosis to establish in the critically ill patient because of the presence of underlying cardiopulmonary disorders (e.g., pulmonary contusion, acute respiratory distress syndrome, atelectasis) and the nonspecific radiographic and clinical signs associated with this infection. However, the escalating antimicrobial resistance of the bacterial pathogens associated with ventilator-associated pneumonia, as well as with other nosocomial infections, has created an imperative to reduce their occurrence and the unnecessary use of antibiotics. Hospital-based process improvement initiatives aimed at the prevention of ventilator-associated pneumonia, and other ventilator-associated complications, have been successfully used despite the limitations of clinical criteria for establishing the diagnosis of ventilator-associated pneumonia. Given current restrictions in hospital resources, absence of available new antimicrobial agents, and potential lack of reimbursement for patients with development of ventilator-associated pneumonia, hospitals need to develop and successfully implement programs aimed at reducing ventilator-associated pneumonia. The use of evidence-based bundles targeting ventilator-associated pneumonia seems to be a reasonable first step in addressing this important clinical problem.

From the Department of Medicine, Washington University School of Medicine, St. Louis, MO.

* See also p. 348.

Dr. Kollef's effort was supported by the Barnes-Jewish Hospital Foundation.

The author has not disclosed any potential conflicts of interest.

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© 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins