Too passive to prevent ventilator-associated pneumonia.

Ventilator-associated pneumonia (VAP) is a common complication of patients receiving invasive mechanical ventilation support. VAP continues to be associated with high morbidity, mortality, hospital cost ($10,000 to $25,000) and ICU stay.1 Depending on the definition used, the VAP rate ranges from 1.2 to 8.5 cases per 1,000 ventilators days.2 Prevention of complications and patient safety is currently a priority in the United States healthcare administration, and VAP is proposed as a quality-of-care indicator and a preventable disease. A rate of zero VAP has been encouraged and reported using the National Healthcare Safety Network.3 However, the importance of this zero rate remains unclear, especially when external pressure to report a low VAP rate and to limit reimbursement might be present.4 Therefore, initiatives that may prevent VAP and can consistently sustain successful results are matters of great interest for patients, families, healthcare provides, and healthcare systems.