Course Summary

Ventilator-associated pneumonia (VAP) is a major health concern when  caring for critically-ill patients. Although the incidence of VAP has decreased with the implementation of care bundles, VAP continues to pose a high risk of infection in Intensive Care Units and is the main reason for ventilated patients to be administered antibiotic therapy. While VAP is reported to have a low mortality rate, there is significant morbidity and healthcare costs associated with VAP, including prolonged ICU-length and hospital-length of stay. Screening and diagnostic criteria exist to diagnose VAP early in its development. The Centers for Disease Control and Prevention (CDC) have established a surveillance strategy (2013) that is a major shift in the VAP diagnosis and treatment model, which focuses on sustained hypoxemia and worsening oxygenation. Ventilator-associated pneumonia diagnosis and treatment continues to evolve. Successful treatment currently includes early diagnosis, immediate initiation of antibiotic therapy, an individualized approach to patient treatment and response to antibiotic medication and to supportive bedside care.

Course Format

Homestudy

Course Syllabus

• I.       Introduction
• II.      Etiology and Epidemiology of VAP
• III.     VAP versus Community-acquired Pneumonia
  • 1.        Community Acquired Pneumonia
• IV.     Mechanical Ventilation
  • 1.   Indications
  • 2.   Goals of Treatment
• V.      Pathophysiology of VAP
• VI.     VAP Risk Factors
  • 1.      Ventilation for 5+ Days
  • 2.      Recent Hospitalization
  • 3.      Long-term Care Facilities
  • 4.      Hemodialysis Treatment
  • 5.      Chemotherapy, Intravenous Therapy and Wound Care
  • 6.      Recent Antibiotic Use
  • 7.      Patient Immunity
• VII.     Symptoms of VAP
  • 1.      Fever
  • 2.      Purulent Sputum
  • 3.      Leukocytosis
  • 4.      Low Body Temperature
  • 5.      Hypoxemia
  • 6.      Ventilator-associated Event
• VIII.    Diagnosis of VAP/VAE
  • 1.      Laboratory Testing
  • 2.      Chest X-Ray
  • 3.      Culture
  • 4.      Bronchoscopy
  • 5.      Bronchoalveolar Lavage
  • 6.      Clinical Pulmonary Infection Score
• IX.     Treatment of Ventilator-associated Pneumonia
  • 1.      Empiric Therapy
  • 2.      Targeted Drug Therapy
• X.      Patient Care
  • 1.   Feeding and Body Positioning
  • 2.   Intubation Considerations
  • 3.   Oral Care
  • 4.   Prognosis of VAP
• XI.     Case Study: Ventilator-associated Pneumonia
• XII.    Summary

Author

Noah H. Carpenter, MD

Dr. Noah Carpenter is a Thoracic and Peripheral Vascular Surgeon. He completed his Bachelor of Science in chemistry and medical school and training at the University of Manitoba. Dr. Carpenter completed surgical residency and fellowship at the University of Edmonton and Affiliated Hospitals in Edmonton, Alberta, and an additional Adult Cardiovascular and Thoracic Surgery fellowship at the University of Edinburgh, Scotland. He has specialized in microsurgical techniques, vascular endoscopy, laser and laparoscopic surgery in Brandon, Manitoba and Vancouver, British Columbia, Canada and in Colorado, Texas, and California. Dr. Carpenter has an Honorary Doctorate of Law from the University of Calgary, and was appointed a Citizen Ambassador to China, and has served as a member of the Indigenous Physicians Association of Canada, the Canadian College of Health Service Executives, the Science Institute of the Northwest Territories, Canada Science Council, and the International Society of Endovascular Surgeons, among others. He has been an inspiration to youth, motivating them to understand the importance of achieving higher education.