Noninvasive Mechanical Ventilation to Prevent Intensive Care Unit-Acquired Infection

Abstract

Although invasive mechanical ventilation (IMV) is an effective technique for supporting alveolar ventilation, it has many associated complications. In intensive care unit (ICU) patients, nosocomial infections are major causes of mortality and morbitidy. The use of invasive devices such as the endotracheal tube is the most important factor for producing nosocomial infections [1]. Ventilator-associated pneumonia (VAP)—defined as the development of parenchymal lung infection after at least 48 h of IMV—is the most common nosocomial infection in the ICU. It is associated with prolonged hospitalization, increased health care costs, and mortality. The incidence of VAP ranges from 6 to 52 %. The risk increases at a rate of 1–3 % for each day that a patient is on IMV. The main pathogenic mechanism for the development of VAP is aspiration of colonized oropharyngeal secretions at the time of intubation or throughout the period on IMV. The risk factors for VAP are shown in Table 31.1.