Postoperative pneumonia.

Despite the advances made in surgical critical care, the diagnosis of one of the most common infections seen in critically ill patients remains a challenge. Ventilator-associated pneumonia is associated with a 20 to 25 per cent mortality rate. There are numerous risk factors for ventilator-associated pneumonia, including underlying disease, prolonged mechanical ventilation, direct lung injury, and shock. The standard clinical criteria for pneumonia are inaccurate. Quantitative cultures of bronchoalveolar lavage effluent are accurate for the diagnosis, and it is safe to base antibiotic therapy on the results of the quantitative cultures.