Adherence to evidence-based recommendations for prevention of ventilator-associated pneumonia: the survey says...

Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit;1 between 10% and 20% of patients who receive more than 48 hours of mechanical ventilation will develop VAP.1,2 VAP is associated with prolonged hospital stay,3–5 higher cost,6 and a 2-fold higher risk of mortality.2 Prevention of VAP is essential. Recent advances in our understanding of the pathogenesis of VAP have led to the development of effective strategies for prevention.7 Several recent guidelines for the prevention of VAP have been published,8–10 which recommend adoption of strategies found to be efficacious in randomized trials for reducing the incidence of VAP. It has become obvious, however, that such proof of efficacy, though necessary, is not sufficient for these measures to become part of clinical practice.11