Comparison of ventilator associated pneumonia between pulmonary and non-pulmonary indications for mechanical ventilation

Abstract

BACKGROUND: Ventilator associated pneumonia (VAP) is among the most prevalent illnesses that are acquired in hospitals. VAP develops in about 10% of patients who need mechanical breathing, with a 20–50% fatality rate world wide. In India, the incidence has been estimated to be around 27%. VAP is defined as pneumonia or infection in lung parenchyma acquired in patients after invasive mechanical ventilation after 48–72 hours. It is associated with high morbidity, mortality, prolonged hospital stay, and cost of treatment. The indications for mechanical ventilation could be due to pulmonary or non-pulmonary causes like, acute hypoxemic respiratory failure, hypoventilation, hemodynamic compromise, cardiorespiratory arrest, stroke, traumatic brain injury, and the incidence of VAP in these conditions differs accordingly. There are various scores available for early diagnosis of VAP and to predict the outcomes and mortality of the patients on mechanical ventilation. While the Clinical Pulmonary Infection Score (CPIS) aids in diagnosis of VAP, Sequential organ function assessment (SOFA) score is a widely used tool for predicting mortality in septic ICU patients, whereas Acute physiology and chronic health evaluation (APACHE II) score predicts the outcome and duration of Mechanical ventilation