الفهرس 
Ventilator Associated PneumoniaOnly 14 pages are availabe for public view
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Abstract
Ventilator-associated pneumonia (VAP) is a subset of hospital acquired pneumonia (HAP) that occurs in mechanically ventilated patients more than 48 h after the initiation of endotracheal intubation and mechanical ventilation (MV), VAP is the most frequent ventilatorassociated complication (VAC). VAP represents a major cause of deaths, morbidity and resources utilization in hospitalized patients, most notably in those with severe underlying conditions. The pathogenesis of VAP, is related to the numbers and virulence of microorganisms entering the lower respiratory tract and the response of the host. The primary route of infection of the lungs is through microaspiration of organisms, which have colonized the oropharyngeal tract (or to lesser extent the gastrointestinal tract). Diagnosis of VAP is dependanton the clinical criteria (CPIS> 6), the microbiological criteria, and the radiological criteria. Biomarkers were developed to help diagnosis, assess prognosis and to follow up treatment, of those biomarkers procalcitonin and CRP were clinically studied and evaluated. Empirical treatment of VAP is based on the presence or absence of risk factors for MDR pathogens. The choice of the antibiotics is based on the susceptibility pattern oflocal microbial flora, cost, feasibility and availability. De-escalation’ strategy is a promising approach for effective delivery of appropriate empiric therapy for VAP, without the overuse of antibiotics.