Novel Therapies in the Prevention of Ventilator-associated Pneumonia
The pathogenesis of ventilator-associated pneumonia (VAP) is iatrogenic and multifactorial . Many of the known risk factors relate to the presence of an endotracheal or tracheostomy tube which bypass many of the patient’s protective mechanisms and increase the chances of upper and lower airway colonization, aspiration, and infection . The sequence of colonization of the aerodigestive tract, followed by the tracheal tube and then ventilator circuit has been elegantly described by Feldman . This sequence begins with oropharyngeal colonization after 1–2 days, followed by colonization of the stomach, then the lower respiratory tract (2–4 days), and thereafter the endotracheal tube. A reflection of the importance of the artificial airway has led some authorities to refer to the condition as “tracheal tube-associated pneumonia” .
KeywordsEndotracheal Tube Tracheal Tube Tracheostomy Tube Pulmonary Aspiration Selective Digestive Decontamination
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