NOSOCOMIAL PNEUMONIA - DIAGNOSIS AND PREVENTION

Ventilator-associated pneumonia (VAP) is an important complication in patients with respiratory failure who undergo endotracheal intubation and mechanical ventilation. VAP cannot be accurately diagnosed by clin ical or radiographic criteria or culture of endotracheal aspirates; ho wever, it can be accurately diagnosed by histopathologic examination o f lung tissue, rapid cavitation of a pulmonary infiltrate, culture of empyema fluid, percutaneous lung needle aspiration, simultaneous recov er]; of the same microorganism from cultures of respiratory secretions , and blood and quantitative culture of lower respiratory tract secret ions obtained by bronchoscopy. VAP can be prevented by proper decontam ination and use of ventilatory support equipment, practice of proper n ursing techniques during care of the mechanically ventilated patient, and use of face mask ventilation in selected patients.