Diagnosis
A diagnosis of ventilator-associated pneumonia is made when the patient has a new diagnosis of pneumonia after having mechanical ventilation initiated. VAP should be suspected in any person on mechanical ventilation exhibiting increasing numbers of white blood cells on blood testing, and new shadows (infiltrates) on a chest x-ray as is indicative of a pneumonia. Blood cultures may reveal the microorganisms causing VAP.
Two strategies exist for diagnosing VAP. One strategy collects cultures from the trachea of people with symptoms of VAP plus a new or enlarging infiltrate on chest x-ray. The other is more invasive and advocates a bronchoscopy plus bronchoalveolar lavage (BAL) for people with symptoms of VAP plus a new or enlarging infiltrate on chest x-ray. In both cases, VAP is not diagnosed when cultures are negative and another source of the symptoms is sought.
Read more about this topic: Ventilator-associated Pneumonia