Definition

Ventilator-associated pneumonia (VAP) is a lung infection that affects people who are on mechanical ventilation. Pneumonia affects the small airways and air sacs in the lungs. It can make it hard for oxygen to pass into the body.

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Causes

This problem is commonly caused by a specific bacterium. Mechanical ventilation can increase the risk of pneumonia. The tube that is needed in the throat makes it easier for bacteria to get deep into the lungs.

Risk Factors

This problem is more common in older adults. Other things that may raise the risk of this problem are:

• Chronic lung disease
• Conditions that affect the nervous system
• A weakened immune system
• Long term use of antibiotics
• Repeated placement of a tube in the throat
• A tube placed through an opening in the throat rather than down through the nose or mouth
• Long term ventilation
• Continuous sedation
• Long periods of lying on your back
• Poor nutrition

Symptoms

Problems may be:

• Fever
• Chills
• Cough
• Nausea or vomiting
• Thick mucus, greenish mucus, or pus-like phlegm
• Shortness of breath
• Nails or lips that are blue in color

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Your body fluids may be tested. This can be done with:

• Blood tests—to measure oxygen, carbon dioxide, and acid in the blood
• Blood cultures—to look for what may be causing infection
• Cultures from below the chest tube

Images may be taken of the area. This can be done with:

• Chest x-ray—will show fluid or inflammation in lungs
• CT scan

Treatment

The goal is the treat the infection and promote breathing. This can be done with:

• Antibiotics
• Oxygen therapy—to improve the level of oxygen in the body

Prevention

The care team of a person who is on mechanical ventilation will take steps to lower the risk of VAP.