Pieracci Fredric M, Barie Philip S
Department of Surgery , Weill Medical College, Cornell University, New York, New York, USA.
Am Surg. 2007 May;73(5):419-32.
Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality in the intensive care unit. Prevention of VAP is possible through the use of several evidence-based strategies intended to minimize intubation, the duration of mechanical ventilation, and the risk of aspiration of oropharyngeal pathogens. Current data favor the quantitative analysis of lower respiratory tract cultures for the diagnosis of VAP, accompanied by the initiation of broad-spectrum empiric antimicrobial therapy based on patient risk factors for infection with multi-drug-resistant pathogens and data from unit-specific antibiograms. Eventual choice of antibiotic and duration of therapy are selected based on culture results and patient stability, with an emphasis on minimization of unnecessary antibiotic use.
呼吸机相关性肺炎（VAP）是重症监护病房发病和死亡的主要原因。通过采用多种循证策略可预防VAP，这些策略旨在尽量减少插管、机械通气时间以及口咽病原体误吸风险。目前的数据支持对下呼吸道培养物进行定量分析以诊断VAP，并根据患者感染多重耐药病原体的风险因素以及单位特定抗菌谱数据启动广谱经验性抗菌治疗。最终抗生素的选择和治疗持续时间根据培养结果和患者稳定性来确定，重点是尽量减少不必要的抗生素使用。
