Ventilator-associated conditions versus ventilator-associated pneumonia: different by design.

The Centers for Disease Control and Prevention (CDC) released a new surveillance concept called ventilator-associated conditions (VACs) in early 2013. VAC was created to overcome some of the limitations of traditional ventilator-associated pneumonia (VAP) definitions, including their complexity, subjectivity, and insensitivity to complications other than pneumonia. VAC is defined by sustained increases in ventilator support after ≥2 days of stable or decreasing settings. The VAC definition was designed to be objective, reproducible, and amenable to automated analysis. Moreover, VAC purposefully broadens the scope of surveillance to include physiologically significant complications of care in addition to pneumonia, most commonly pulmonary edema, atelectasis, and acute respiratory distress syndrome. VAC definitions offer an opportunity for hospital quality improvement programs to get a fuller picture of the breadth and burden of complications in their critically ill populations and to use these data to catalyze enhanced prevention and control programs to better prevent these conditions.