VAP

Q: Ventilator-associated pneumonia (VAP) also includes patients who develop nosocomial pneumonia (HAP) within 48 hours of extubation.

A) True 

B) False

Answer: A

The term ventilator-associated pneumonia (VAP) can be a little misleading, as it suggests that it counts only pneumonia that occurs while on a ventilator. Patients who are already extubated but still within 48 hours and develop pneumonia are counted as VAP.

Several different terminologies have been designated to categorize these patients. The basic idea for such a classification is that there may be various kinds of 'bugs', often multidrug-resistant (MDR), that are frequently encountered in these different patient categories and can help start appropriate antibiotics before culture results are available.

Hospital-acquired pneumonia (HAP), also known as nosocomial pneumonia, is defined as pneumonia that occurs 48 hours or more after hospital admission and did not appear to be incubating at the time of admission. 

VAP and non-ventilator-associated HAP (nvHAP) are types of HAP.

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References:

1. Kalil AC, Metersky ML, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63:e61.

2. Mumtaz H, Saqib M, Khan W, Ismail SM, Sohail H, Muneeb M, Sheikh SS. Ventilator associated pneumonia in intensive care unit patients: a systematic review. Ann Med Surg (Lond). 2023 May 12;85(6):2932-2939. doi: 10.1097/MS9.0000000000000836. PMID: 37363470; PMCID: PMC10289715.