Ventilator-Associated Pneumonia

What is ventilator-associated pneumonia?

Ventilator-associated pneumonia (VAP) is a lung infection. It can happen after you have been using a machine called a ventilator to help you breathe.

The ventilator helps you breathe by giving oxygen through a tube. The tube may be placed in your mouth or nose or through a hole in the front of your neck.

How does it occur?

VAP can happen after you have been using a ventilator to help you breathe. You may need a ventilator after some surgeries, such as coronary artery bypass surgery. Or you may need it if you have a serious illness, such as a stroke or severe infection.

A ventilator may also be needed if you have had a major injury that keeps you from breathing on your own.

When you are on a ventilator, your risk of lung infection is higher because:

• It’s easier for bacteria to get into your lungs through the ventilator tube. This is especially true if the tube goes through your mouth into your windpipe.
• Your lungs and airways are not able to do their usual job of keeping the lungs healthy by coughing and moving mucus up and out of your mouth.
• Saliva and stomach juices can get into your airways and lungs. These fluids can damage the lungs and cause a type of pneumonia called chemical pneumonia. This condition makes it more likely that you will get a bacterial lung infection, and the infection is more likely to be severe.

What are the symptoms?

The symptoms are like the symptoms of other types of pneumonia:

• fever and chills
• cough
• shortness of breath
• chest pain
• coughing up mucus.

How is it diagnosed?

If you are on a ventilator, your caregivers will carefully watch for symptoms of pneumonia. When VAP is suspected, you will have a chest X-ray and blood tests to look for signs of infection. Samples of fluid from your windpipe may also be tested.

How is it treated?

VAP is treated with antibiotics. The choice of antibiotics depends on which specific germs are causing the infection.

One of the disadvantages of being hospitalized is that it is easier to be exposed to bacteria that have become resistant to many antibiotics. These bacteria are not easily killed by antibiotics. If you are infected with resistant bacteria, your healthcare provider will need to figure out what antibiotics might work. You may need to take antibiotics for 2 weeks or more.

How long will the effects last?

VAP can be life threatening. How long you are ill depends on how long it takes the antibiotics to kill the bacteria. You may need to stay on the ventilator for a longer time. And it will likely take you longer to recover from your illness, surgery, or injury.

How can I help prevent ventilator-associated pneumonia?

It’s usually not possible to avoid being on a ventilator, if your condition requires it. However, once you are on the ventilator, there are several things that doctors, nurses, and other healthcare providers are expected to do to prevent VAP. These include:

• cleaning their hands with soap and water or an alcohol-based hand rub before examining you or adjusting your medical equipment
• cleaning the inside of your mouth regularly
• keeping the head of your bed raised 30 to 45 degrees unless your condition prevents it
• checking your ability to breathe without the ventilator every day, to try to shorten the time you are on the ventilator
• cleaning or replacing equipment between use on different patients.

While you are in the hospital, family members can ask healthcare providers to follow these precautions.

An important factor that you can control is smoking. Smokers have more infections and heal more slowly. If you are planning to have surgery and you smoke, you should stop at least 6 weeks before the surgery. This helps prevent breathing problems during and after surgery. You will also heal faster. Quitting smoking is a powerful way to get healthier and to try to prevent infections.

How can I help take care of myself?

After you leave the hospital:

• Follow your healthcare provider’s instructions for follow-up appointments.
• Take all medicines exactly as prescribed. If you have questions about your medicines, ask your pharmacist or your provider.
• You should rest and then increase your activity according to your provider’s recommendations. Ask for help from family and friends so you can have plenty of time for recovery and avoid a setback.

Call your healthcare provider right away if:

• You have a fever of 100.5°F (38°C) or higher.
• You have chills and sweats.
• You have more shortness of breath or trouble breathing.
• You start coughing up colored mucus.
• You have chest pain.

If you have any questions, be sure to ask your healthcare provider.