Ventilator-Associated Pneumonia: New Definitions

Abstract

The National Healthcare Safety Network's new classification characterizes all adverse ventilator-associated events (VAE) into a tiered system designed to shift the focus away from ventilator-associated pneumonia as the only important cause or morbidity in ventilated patients. This new surveillance definition of VAE eliminates subjectivity by using clearly defined criteria and facilitates the automated collection of data. This allows for easier comparison and analysis of factors affecting rates of VAE. Numerous studies have been published that demonstrate its clinical application. This article presents the VAE criteria, contrasts the difference from the previous ventilator-associated pneumonia definition, and discusses its implementation over the past 5 years.

Keywords: Critical care; Nosocomial infection; Sepsis; Ventilator-associated pneumonia.

Fig. 1

Targeting VAE. Broad description of ventilator-related complications is more narrowly defined by each tier of the new CDC definition: VAC, IVAC, possible- or probable-VAP. Fio₂, fraction of inspired oxygen; PEEP, positive end-expiratory pressure.

Fig. 2

Diagram summarizing cumulative number of patients that met VAC, iVAC, and both possible- and probable-VAP criteria from the published studies summarized in Table 2.