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Prophylaxis of Ventilator-Associated Pneumonia: Changing Culture and Strategies to Trump Disease

Donald E. Craven, MD; Karin Hjalmarson, MD
Author and Funding Information

Correspondence to: Donald E. Craven, MD, Department of Infectious Diseases, Lahey Clinic Medical Center, 41 Mall Rd, Burlington, MA 01805; e-mail: donald.e.craven@lahey.org

Dr. Craven is affiliated with the Department of Infectious Diseases, Lahey Clinic Medical Center and the Tufts University School of Medicine.

Dr. Hjalmarson is affiliated with the Department of Infectious Diseases, Lahey Clinic Medical Center and the Tufts University School of Medicine.


Dr. Craven received research funds from Bard, Inc. for the North American Silver-Coated ENndotracheal Tube (NASCENT Study).

Dr. Hjalmarson has reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(5):898-900. doi:10.1378/chest.08-1735
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Placement of an endotracheal tube (ETT) increases a patient's risk of pneumonia 6-fold to 20-fold by providing bacteria colonizing the oropharynx a convenient, one-way path around the ETT cuff into the lower respiratory tract.14 Crude mortality rates for ventilator-associated pneumonia (VAP) range from 20 to 60% with an estimated cost of $40,000 per episode.1,2 Many of these poor outcomes result from system failures that are preventable with changes in hospital culture.2,3,5

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