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Ventilator-Associated Pneumonia in the Neonatal Intensive Care Unit
Ayesha Alriyami1, James R Kiger1,2, Thomas A Hooven1,2,3
1Division of Newborn Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Neoreviews
|June 30, 2022
Summary
Ventilator-associated pneumonia (VAP) is a risk for intubated infants in the NICU. This review covers VAP
Area of Science:
- Neonatal Medicine
- Critical Care
- Infectious Diseases
Background:
- Intubated neonates in the NICU are susceptible to ventilator-associated pneumonia (VAP), a significant healthcare-associated infection.
- Current diagnostic guidelines for VAP in infants under one year involve clinical signs, radiographic evidence, and gas exchange.
- Treatment typically involves empiric antibiotics tailored to local resistance patterns and patient specifics.
Purpose of the Study:
- To review the epidemiology, pathogenesis, diagnosis, treatment, and prevention of VAP in NICU patients.
- To focus on recent evidence and highlight emerging research areas.
- To identify persistent knowledge gaps in VAP management.
Main Methods:
- Review of current literature on VAP in neonatal intensive care units (NICUs).
- Analysis of diagnostic criteria and treatment strategies.
- Examination of VAP prevention bundles and their evidence base.
Main Results:
- VAP diagnosis in infants involves specific clinical, radiographic, and gas exchange criteria.
- Antibiotic selection for VAP is guided by local resistance and individual patient data.
- Prevention strategies include hygiene, sterile techniques, positioning, and readiness for extubation, though robust research support is limited.
Conclusions:
- VAP remains a concern in NICU settings, necessitating ongoing research.
- Evidence supporting current VAP prevention bundles requires strengthening.
- Further research is needed to address knowledge gaps in VAP pathogenesis, diagnosis, and effective prevention.
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