OBJECTIVE To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilator-associated pneumonia. METHODS A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; o...

Ventilator-associated pneumonia (VAP) is an important source of morbidity and mortality in critically ill patients. Many interventions are touted to prevent VAP but studies supporting these interventions are difficult to interpret owing to an exceedingly poor correlation between clinical diagnosis of VAP and the presence of an invasive pneumonia. There is consequently a risk that purported decr...

It is interesting to observe how advances in research, as well as unmet medical needs, change attitudes and decisions in clinical practice. The expansion of use of intravenous colistin for the treatment of patients with multidrug-resistant (MDR) gram-negative bacterial infections is certainly such an example. Even a few years ago there were many opponents to the use of colistin. The medication ...

Ventilator-associated pneumonia (VAP) management depends on the interaction between the infective agent, the host response, and the antimicrobial drug used. After the pathogen reaches the lungs, two outcomes are possible: either the microorganisms are eliminated by the host immune system, or they overcome the immune system and cause pulmonary infection. When a patient is thought to have VAP, tw...