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Ventilator-Associated Pneumonia

Author: Noah H. Carpenter, MD

CE: 2.5 hours Pharmacology: 0.5 hour
Rated 4.7 out of 5.0 based on 1989 reviews

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

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