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Ventilator-Associated Pneumonia


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Overview

Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in a person who has been on a ventilator.  A ventilator is a machine that helps a person breathe by giving oxygen through a tube placed in the mouth, nose, or through a hole in the front of the neck.  Germs can enter the ventilator and get into the patient’s lungs, causing illness.

Factors that may increase a patient’s risk of developing VAP include prolonged intubation, enteral feeding, witnessed aspiration, paralytic agents, underlying illness, and age.  It is important that both the patient and the healthcare providers take the appropriate steps to help prevent an infection.

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Estimated burden of VAP in acute care facilities in the United States:

  • Morbidity
    • Pneumonia infections are the most common type of HAI. (citation)
      • 22% of HAIs reported, comprising an estimated 157,500 infections annually. 
      • More than one-third (39%) of pneumonia infections in acute care hospital settings are estimated to be ventilator-associated.
      • An estimated 49,900 ventilator-associated pneumonia infections occur in non-neonatal intensive care units annually.
    • VAP rates may exceed 10 cases per 1,000 ventilator days in some neonatal and surgical patient populations (citation)
    • Patients with VAP require long period of mechanical ventilation, extended hospitalizations, and increased use of antibiotics. (citation)
  • Mortality (citation)
    • The mortality attributable to VAP may exceed 10%
  • Costs (citation)
    • Estimated cost per infection ranges from $14,000 - $29,000
    • Estimated total cost in the United States ranges from $0.8 billion - $1.5 billion annually

Prevention Strategies for Healthcare Providers
To prevent ventilator-associated pneumonia, doctors, nurses, and other healthcare providers can do the following things:

  • Keep the head of the patient’s bed raised between 30 and 45 degrees unless other medical conditions do not allow this to occur.
  • Check the patient’s ability to breathe on his or her own every day so that the patient can be taken off of the ventilator as soon as possible.
  • Clean their hands with soap and water or an alcohol-based hand rub before and after touching the patient or the ventilator.
  • Clean the inside of the patient’s mouth on a regular basis.
  • Clean or replace equipment between use on different patients.

 

SHEA/IDSA Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals - VAP

 

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Tools and Resources

APIC Guide to the Elimination of Ventilator-Associated Pneumonia, 2009

Guidelines for Preventing Healthcare-Associated Pneumonia, 2003

NHSN Ventilator-Associated Event (VAE) protocol, training, forms, analysis resources, and support materials – click on the appropriate healthcare setting and select the VAE link to access the materials

SHEA Patient Education Guide (VAP) – fact sheet that educates patients and their families about 7 types of HAIs (including VAPs) and how to work with healthcare professionals to prevent them.

For more patient resources, please see the Consumer and Public Information page or go to the CDC VAP website.

Citation:
Magill SS, Edwards JR, Bamberg W, et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014;370:1198-208. To access the full article, link through this website: http://www.cdc.gov/HAI/surveillance/index.html (click top link)

 


Last Updated: 04-03-2014

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