Prevention of ventilator associated pneumonia in an intensive care unit

: Important pathogenic mechanisms in ventilator associated pneumonia (VAP) are pharyngeal colonization, micro-aspiration, and exogenously acquired pathogens. Semirecumbent positioning, subglottic suctioning, non-invasive ventilation, oropharyngeal application of chlorhexidine or antibiotics, and selective digestive decontamination (SDD) have all been shown to lower the incidence of VAP. However, regular use of SDD is not recommended in recent guidelines due to the risk of antimicrobial resistance. High hygienic standards and routine surveillance of VAP incidence are mandatory.