LITERATURE REVIEWLiterature ReviewIn patients who are critically ill, endotracheal intubation and ventilator assisted breathingare sometimes necessary to preserve life. But, as with any medical intervention, there arepotential complications associated with these measures. The most common of these beingventilator-associated pneumonia, also known as VAP. Ventilator-associated pneumonia is mostcommonly caused by the micro-aspiration of gastric content into the lungs. VAP is defined aspneumonia that occurs after a patient has been mechanically ventilated for more than 48 hours.The occurrence of ventilator-associated pneumonia increases the length of stay in the intensivecare unit (ICU) as well as the morbidity and mortality rate in those particular patients.Nosocomial infections, such as VAP, also account for a significant increase in the cost of healthcare. Pneumonia is the second leading nosocomial infection in patients who are critically ill with86% of all nosocomial pneumonias being attributed to mechanical ventilation (Koenig & Truwit,2006). There have been many research studies on the prevention of VAP and as nurses it isimportant for us to use this research as a guideline for care. Preventing VAP is not only what isbest for the patient but it also important to the facilities in which these patients are cared for. Asan ICU nurse, I have been witness to the negative outcomes associated with VAP and would loveto see the prevalence of this infection decrease tremendously. One of the leading studies on VAPis whether or not patient positioning effects the occurrence of VAP. But does it really make thatbig of a difference? This literature review will explore the evidence gathered on the subject andhopefully answer the following question. In ventilated patients, what is the effect of the semi-recumbent position on VAP compared to supine positioning?2
