Hi guys,

what is your approach to Ventilation Associated Pneumonia VAP?

What is your definition?

Do you routinely send ETT aspirations for culture? And do you use blinded end catheter?

Do you treat colonisation?

I am asking because it is a source of continuous excuse to keep babies on antibiotic with no clear benefit 

very interested in hearing your thoughts 

Very controversial topic.

No definition in the neonatal period.

We do not treat colonization.

We do have the CDC definition in infant less one year, however it can not be applied to the prem with evolving chronic lung disease. 

It includes clinical, radiological, and microbiological aspect for the diagnosis. Most of these can be applied early to the ventilated prem with BPD. in addition, it is recommended to use a Blind protected catheter for sample collection. 

Sadly, it is a common cause to start antibiotics when lung condition does not improve or get worst, we start looking for causes and ET aspirate is the easiest source to justify antibiotics.