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Ventilator-Associated Pneumonia: Definition and Diagnosis

Ventilator-associated pneumonia (VAP) is defined as a pneumonia occurring in patients requiring, intermittently or continuously, mechanical ventilation through a tracheostomy or endotracheal tube for more than 48 hours. 


Diagnostic criteria for VAP are as follows:

  • New, worsening or persistent infiltrate consolidation or cavitation on CXR compatible with pneumonia and 1 of:

    • WBC greater or equal to 12 000 or less than 4 000

    • Temperature greater than 38 decrees Celsius or less than 36 degrees Celsius with no other recognized cause

  • And both of the following:

    • New onset of purulent sputum, or change in character of sputum, or increase in respiratory secretions or increase in suctioning requirements

    • Worsening gas exchange (e.g. increasing oxygen requirements, worsening PaO2/FiO2 ratio, increasing in minute ventilation)

  • And 

    • The patient is being treated with antibiotics for VAP

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