does re-intubation increased risk of ventilator- associated pneumonia (vap) in pediatric intensive care unit patients?

introduction:ventilator- associated pneumonia(vap),as defined by the centers for disease control and prevention (cdc),is a pneumonia that occurs in a patient receiving mechanical ventilation that develops 48 hours or more after initiation of ventilation.re-intubation which occur within 72 hours of planned extubation may effect vap incidence.the aim of this study was to determine vap incidence in re-intubated patients in comparision with patients underwent intubation without re-intubation to highlight re-intubation as a risk factor for vap .methods and materials: 1230 intubated patients ,admitted to picu department were enrolled in this cohort observational study consecutively from may 2010 to may 2014.vap was clinically suggested and confirmed by chest x-ray .patients demographic data,underlying disease,duration of mechanical ventilationlength of picu stayand re-intubations were recorded prospectively. this study was approved by the institute,s ethics committee.results: 336 intubated patients out of 1230 patients admitted to picu department developed vap(27%) with higher incidence in reintubated patients(30% vs 12%).conclusion: vap developed in nearly one third of intubated patients in our study.re-intubation was significant risk factor for development of vap.