Whether ventilator-associated pneumonia is a manifestation of severity of illness or an independent cause of mortality in ventilator-dependent patients is not known. In this complex area, which cannot be readily subjected to randomized controlled trials, studies should focus on the underlying questions of relevance, how to improve care of ventilated patients.

Dezfulian C, Shojania K, Collard HR, et al. Subglottic secretion drainage for preventing ventilator-associated pneumonia: a metaanalysis. Am J Med 2005;118:11–8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....

s from 1436 Other Journals Professional 1594 Opportunities

Because of its resistance profiles, Pseudomonas aeruginosa remains probably one of the challenging bacteria responsible for ventilator-associated pneumonia in the ICU. Nevertheless, a much better understanding of its mechanism of virulence, such as the type 3 secretion system that can also impact on resistance, gives some opportunities for management improvement. The most promising approach is ...

In 1991, heat-and-moisture exchangers were introduced with biweekly ventilator circuit tubing changes, resulting in elimination of multiple pieces of respiratory equipment and reduced labor costs. The annual savings were $157,000, totalling $1.5 million since the onset of the program. There have been no increases in rates of ventilator-associated pneumonia.