Critical Care/Respiratory CareTracheostomy in Ventilator-associated Pneumonia Is it Preventive?Makris, Demosthenes MD, PhD*,†; Nseir, Saad MD*Author Information *Intensive Care Unit, Calmette Hospital, University Hospital of Lille, boulevard du Pr Leclercq, Lille Cedex, France †Intensive Care Unit, University Hospital of Larisa, Greece Financial support: None. Address correspondence to: Saad Nseir, MD, Réanimation Médicale, Hôpital Calmette, CHRU, boulevard du Pr Leclercq, 59037 Lille cedex, France. e-mail: [email protected]. Clinical Pulmonary Medicine: May 2011 - Volume 18 - Issue 3 - p 129-136 doi: 10.1097/CPM.0b013e318218c604 Buy Metrics Abstract Tracheostomy is considered as a strategy that may improve respiratory mechanics and patient comfort and help in the management of secretions and weaning. Tracheostomy has also been suggested as a measure to decrease the risk of development of ventilator-associated pneumonia (VAP), compared with translaryngeal intubation. However, it has not been established whether tracheostomy is an effective strategy for VAP prevention. Data from observational and randomized trials found conflicting results on the relationship between tracheostomy and VAP. A recent large randomized, multicenter, well-designed and conducted study failed to demonstrate a significant reduction in VAP rate in patients who received early compared with late tracheostomy. Physicians' attitudes regarding tracheostomy may be heterogeneous across different intensive care units and the decision to perform tracheostomy is still challenging. In the present article, we therefore aimed to determine the relationship between VAP and tracheostomy, and whether available data suggest that tracheostomy can prevent the occurrence of VAP. © 2011 Lippincott Williams & Wilkins, Inc.