Diagnosis of ventilator-associated pneumonia

Ventilator-associated pneumonia is a frequent complication of mechanical ventilation, and it carries a significant added mortality. Proper recognition and treatment of pneumonia are associated with improved outcome. Clinical manifestations of pneumonia, chest radiograph findings, and routine analysis of the tracheal aspirate are inadequate, alone or in combination, in diagnosing pneumonia. This article discusses the methodologies that are presently available for diagnosing pneumonia in ventilated patients. Correct use of these techniques helps the clinician to establish a diagnosis with a high degree of reliability and facilitates the rational use of antibiotic treatment.