The author discusses the pathophysiology of ventilator-associated pneumonia, risk factors for this type of pneumonia, and strategies that may prevent the disease.

Pneumonia is the second most common nosocomial infection in the United States and is a leading cause of death due to hospital-acquired infections.1 Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that occurs in patients receiving mechanical ventilation for longer than 48 hours.2 The incidence of VAP is 22.8% in patients receiving mechanical ventilation,3 and patients receiving ventilatory support account for 86% of the cases of nosocomial pneumonia.4 Furthermore, the risk for pneumonia increases 3- to 10-fold in patients receiving mechanical ventilation.5 

VAP is associated with increases in morbidity and mortality, hospital length of stay, and costs. The mortality rate attributable to VAP is 27% and has been as high as...

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