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Grand Rounds |

Preventing Ventilator-Associated Pneumonia:  Does the Evidence Support the Practice?

Naomi P. O’Grady, MD; Patrick R. Murray, PhD; Nancy Ames, RN, PhD
JAMA. 2012;307(23):2534-2539. doi:10.1001/jama.2012.6445.
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Ventilator-associated pneumonia (VAP) is among the most common infections in patients requiring endotracheal tubes with mechanical ventilation. Ventilator-associated pneumonia is associated with increased hospital costs, a greater number of days in the intensive care unit, longer duration of mechanical ventilation, and higher mortality. Despite widely accepted recommendations for interventions designed to reduce rates of VAP, few studies have assessed the ability of these interventions to improve patient outcomes. As the understanding of VAP advances and new technologies to reduce VAP become available, studies should directly assess patient outcomes before the health care community implements specific prevention approaches in clinical practice.

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Figure 1. Chest Radiograph and Computed Tomography Scan of the Case Patient’s Lungs
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Both A and B show diffuse pulmonary infiltrates.

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Figure 2. Lung Pathology
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Lung parenchyma showing abundant bacterial elements (hematoxylin-eosin stain; original magnification ×40).

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