Immobile intensive care unit (ICU) patients are at risk for many complications. Those patients who require mechanical ventilation and who are unable to get out of bed because of their underlying condition and sedation requirements are at risk for ventilator-associated pneumonia (VAP). VAP is due to the colonization of the oropharynx and tracheal airway with bacteria and the aspiration of oropharyngeal secretions into the lower airway.1 The Centers for Disease Control and Prevention2 has established criteria to diagnose VAP that include gross aspiration by the patient, laboratory and radiological findings, and signs and symptoms. VAP occurs in up to 25% of ventilator patients, usually within 3 to 10 days of intubation. This incidence is a concern because VAP is the most common hospital-acquired infection.3 Mechanical ventilation alone costs an average of $1522 per day,4 and VAP can increase a patient’s hospital bill by$40 000.3...