Evidence Based Approach to Ventilator Acquired Pneumonia - Essay Example

These include VAP predisposing factors, diagnosis criteria, duration of chemotherapy, preventive measures, role of invasive techniques and the role of awareness programs (Langer et al., 1987). Chastre, J. & Fagon, Y. (2008). Ventilator-associated pneumonia. American Journal of Respiratory Critical Care, 165 (7), 867-903. The effective duration of antibiotic use is not clear. The research done by Chastre & Fagon aimed at identifying the relative efficacy of an eight day regimen compared to a fifteen day regimen.

Antibiotic chemotherapy is crucial in the management of VAP since it usually caused by bacteria. According to Chastre & Fagon, a short duration regimen would have the benefit of decreased development of drug resistance, but the patients would have lower survival rates (2008). This inference was made due to the observation that more people died after the eight day therapy but, the occurrence of drug resistance incase of relapse was lower in these people. This document will used as an inference as it elaborates on the relationship on chemotherapy and decreased mortality of VAN. Cook, J..

, Walter, D., Cook, J., Griffith, E., Guyatt, H., Leasa, D., Jaeschke, Z., & Buison, C.(1998). Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. . This journal is based on research carried out in Canadian hospitals and utilised one thousand and fourteen sick people admitted in these hospitals. This large sample size coupled with the prospective cohort method of research also used was ideal in the coming up of reliable results to establish the predisposing factors.

According to Cook et al., the key predisposing factor was the duration of time spent at the intensive care unit (1998). This was because most of the patients who acquired VAP had stayed in this specialised care area for more than five days. Other associated factors include body injury, burns, respiratory disease, cardiovascular disease, neurologic disease, paralysis and regurgitation of gastric contents into the airways. Iregui, M., Ward, S., Sherman, G., Fraser, J.V., & Kollef, M.H. (2002). Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia. Chest. 122 (1), 262-268.

In addition to the duration of antibiotic use, another important parameter that influences the outcome of VAP is the time taken since diagnosis up to the time when antibiotic therapy is initiated in the patient. Iregui et al. cite that a delay in prescription is the most common reason that leads to an increased time interval (2002). In their research, Iregui et al concluded that the delay was associated with increased morbidity and mortality of patients (2002). Therefore, it is necessary to undertake a swift diagnosis and prescription processes for these patients. Fagon. J, Wolf, M.

, Gervais, C., Aubas, S., Stephan, F., Similowski, T., Mercat, A., Diehl, J.Sollet, P., Tenaillon, A. (2000). Invasive and non-invasive strategies for management of suspected ventilator-associated pneumonia. Annals of internal medicine, 133