الفهرس 
Bronchoscopy
Inflammatory markersOnly 14 pages are availabe for public view
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Abstract
Ventilator-associated pneumonia (VAP) is defined as pneumonia acquired more than 48 hours after intubation and caused by a colonization of the upper airway followed by subsequent replication of bacteria in the lower respiratory tract(1, 2). It is a common iatrogenic pulmonary infection in patients who are critically ill and receiving mechanical ventilation. Ventilator-associated pneumonia (VAP) occur in up to 25% of mechanically ventilated patients, with an associated mortality up to 50%. VAP is associated with increased ventilator days, increased intensive care unit (ICU) and hospital length of stay, and excess hospital charges. Trauma patients requiring intubation and mechanical ventilation mainly for posttraumatic disorders of consciousness, are at high risk of respiratory complications. Patients with traumatic brain injury (TBI) are at increased risk for aspiration and pneumonia(7). Aspiration events occur in about two out of three patients with severe TBI and are more likely to cause pneumonia if there is a large burden of microorganism, a particularly virulent organism, or impaired host defense(8) . The incidence, risk factors, and association with the outcome of VAP among trauma patients vary widely among studies. Some reports suggest that VAP is associated with an increased risk for mortality, poor neurological outcome, and increased hospital and ICU and length stay (LOS)(9). However, there is substantial uncertainty regarding the incidence and risk factors for VAP development and whether they affect outcome in the specific population of prolonged ventilated trauma patients.