Prevention of ventilator-associated pneumonia. An attainable goal?

Nosocomial pneumonia is a common and serious problem among hospitalized patients, particularly those treated with mechanical ventilation. This article discusses infection control, the role of respiratory therapy equipment and endotracheal tubes, mobilization of tracheobronchial secretions, the role of the gastrointestinal tract, nutritional support and the role of the stomach, prophylactic antibiotics, and immunomodulation. Although there are no proven modalities for immunoprophylaxis of nosocomial pneumonia, it is possible that early administration of a single agent or combination of immune modulators may prove effective in reducing the mortality associated with nosocomial pneumonia.