Acute Care/Hospitalization

Ventilator-associated pneumonia is a serious and costly side effect of mechanical ventilation

Critically ill patients, such as those suffering cardiac arrest, head trauma, shock, or spinal cord injury, sometimes cannot breathe on their own and require mechanical ventilation. Ventilator-associated pneumonia (VAP) is a potentially life-threatening and costly problem among patients undergoing mechanical ventilation, according to a study supported in part by the Agency for Healthcare Research and Quality (HS11540). Researchers found that between 10 percent and 20 percent of patients receiving more than 48 hours of mechanical ventilation developed VAP. Also, critically ill patients in intensive care units (ICUs) who developed VAP were twice as likely to die compared with similar patients who did not develop VAP. Patients with VAP had significantly longer stays in the ICU (an average of 6.10 days) and incurred $10,019 or more in additional hospital costs.

These findings were based on a systematic review of studies of the clinical and economic consequences of VAP. Researchers selected studies published after 1990, since the management and epidemiology of VAP has changed considerably over time. They extracted data on patient population, diagnostic criteria for VAP, incidence, outcome, type of ICU, and study design, identifying a total of 89 studies that assessed the risk of VAP in patients receiving mechanical ventilation.

See "Clinical and economic consequences of ventilator-associated pneumonia: A systematic review," by Nasia Safdar, M.D., M.S., Cameron Dezfulian, M.D., Harold R. Collard, M.D., and Sanjay Saint, M.D., M.P.H., in the October 2005 Critical Care Medicine 33(1), pp. 2184-2193.

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