What is VAP?

Ventilator-associated pneumonia (VAP) is pneumonia that develops in a patient who has been mechanically ventilated for longer than 48 hoursKalil, 2016National Institute for Health and Care Excellence (NICE), 2014Torres, 2017. Intubation significantly increases the risk of pneumonia because it interferes with physiological mechanisms that limit bacterial contamination of the airways.

For pneumonia developing within 48 hours of intubation and mechanical ventilation, treat as for hospital-acquired pneumonia (HAP). If a patient with HAP is deteriorating and requires intubation and mechanical ventilation, manage the patient as for high-severity HAP not VAP.

If a patient with community-acquired pneumonia (CAP) requires intubation and mechanical ventilation, continue to manage the patient as CAP not VAP. To find the right pneumonia topic in these guidelines, see Finding the right pneumonia topic in these guidelines.