Ventilator-associated pneumonia: approaching the horizon.

V entilator-associated pneumonia (VAP) continues to be a disturbing problem in the care of intensive care unit (ICU) patients. Although much progress has been achieved in the past two decades, many issues remain unresolved, and mortality still reaches 30–40% [1, 2]. In this issue of the European Respiratory Journal, two contributions are devoted to VAP. Although quite divergent in scope, they all reflect the many difficulties researchers must face when approaching this issue. After all, it seems that tremendous efforts have to be made to even recognise how such difficulties could be avoided in future, more sophisticated study designs.