Ventilator-Associated Pneumonia
VAP is defined as pneumonia developing in patients who
are mechanically ventilated after more than 48 hours of
intubation, with no clinical evidence suggesting the presence
or probable development of pneumonia at the time
of initial intubation.176 VAP is a leading cause of morbidity
and mortality in patients who are mechanically ventilated
and critically ill. The incidence of VAP is estimated
to be 10% to 25%,177 and the estimated mortality rate
from VAP is 5% to 27%.178 The pathogenetic progression
of VAP probably involves microaspiration of oropharyngeal
or gastric secretions contaminated with bacteria. Risk
factors include previous exposure to antibiotic therapy
and the presence of invasive devices