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Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. As such, VAP typically affects critically ill persons that are in an intensive care unit (ICU) and have been on a mechanical ventilator for at least 48 hours.
Mechanical ventilator. Treatment of the underlying cause is required, if possible. The treatment of acute respiratory failure may involve medication such as bronchodilators (for airways disease), [7] [8] antibiotics (for infections), glucocorticoids (for numerous causes), diuretics (for pulmonary oedema), amongst others.
The mechanical ventilator will often be set to a setting of at least 5 cm H 2 O of positive end-expiratory pressure to keep the alveoli from collapsing during exhalation. [9] Other treatments to improve oxygenation may include prone positioning or extracorporeal membrane oxygenation . [6]
The primary treatment involves mechanical ventilation together with treatments directed at the underlying cause. [1] Ventilation strategies include using low volumes and low pressures. [1] If oxygenation remains insufficient, lung recruitment maneuvers and neuromuscular blockers may be used. [1]
Ventilator-associated lung injury (VALI) is an acute lung injury that develops during mechanical ventilation and is termed ventilator-induced lung injury (VILI) if it can be proven that the mechanical ventilation caused the acute lung injury. In contrast, ventilator-associated lung injury (VALI) exists if the cause cannot be proven.
Ventilator-associated pneumonia (VAP) is a sub-type of hospital-acquired pneumonia (HAP) which occurs in people who are receiving mechanical ventilation. VAP is not characterized by the causative agents; rather, as its name implies, definition of VAP is restricted to patients undergoing mechanical ventilation while in a hospital.
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If the symptoms worsen, the pneumonia does not improve with home treatment, or complications occur, hospitalization may be required. [69] Worldwide, approximately 7–13% of cases in children result in hospitalization, [ 23 ] whereas in the developed world between 22 and 42% of adults with community-acquired pneumonia are admitted. [ 69 ]