Ventilator Associated Pneumonia in Geriatric Intensive Care Unit

Abstract

Hospital-acquired pneumonia is the most common life-threatening hospital-acquired infection, and the majority of cases are associated with mechanical ventilation.

Ventilator associated pneumonia (VAP) occurs 48 hours after intubation and mechanical ventilation. It is a common infectious disease that is found in intensive care unit (ICU), which occurs in 8-38% of patients who underwent mechanical ventilation. The incidence of pneumonia has been known to be higher in ICU patients than in general ward patients and even 3 ~ 10-fold higher in patients who underwent mechanical ventilation .

Time of onset of pneumonia is an important epidemiologic variable and risk factor for specific pathogens and outcomes in patients with HAP and VAP.

1) Early-onset VAP (occurring within the first 4 days of hospitalization) usually carry a better prognosis and are more likely to be caused by antibiotic sensitive bacteria.

2) Late-onset VAP (occurring greater than 4 days after hospital admission) are more likely to be caused by multiple-drug resistant pathogens associated with increased hospital mortality and morbidity .

VAP is the leading cause of nosocomial mortality for patients with respiratory failure. Approximately 60% of all deaths in patients with nosocomial infections are associated with HAP and the mortality rate is higher in critically ill patients and those patients developing VAP.

Risk factors associated with VAP development were grouped into intrinsic factors (individual variable of age, co-morbidity, disease severity, etc.) and extrinsic factors (potential hospital environment risks, prior use of antibiotics, tracheal intubations .