Ventilator-associated tracheobronchitis (VAT): questions, answers, and a new paradigm?

doi:10.1186/cc6912

Critical Care
Volume 12
Issue 3

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Commentary

Ventilator-associated tracheobronchitis (VAT): questions, answers, and a new paradigm?

Donald E Craven¹^,2

¹Department of Infectious Diseases, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA

²Tufts University School of Medicine, Boston, MA, USA

author email corresponding author email

Critical Care 2008, 12:157doi:10.1186/cc6912


Published:	18 June 2008

See related research by Nseir et al., http://ccforum.com/content/12/3/R62

Abstract

Nosocomial lower respiratory tract infections are a common cause of morbidity and mortality in intensive care unit (ICU) patients. Although many studies have investigated the management and prevention of ventilator-associated pneumonia (VAP), few have focused on ventilator-associated tracheobronchitis (VAT). In this issue of Critical Care, Nseir and coworkers present interesting data from a randomized controlled study of antimicrobial therapy for VAT. Patients randomly assigned to antibiotic therapy had more mechanical ventilation-free days (P < 0.001), fewer episodes of VAP (13% versus 47%; P < 0.001), and a lower ICU mortality rate (18% versus 47%; P = 0.05) than those without antibiotic therapy. Although this study has limitations, the data suggest that VAT may be an important risk factor for VAP or overlap with early VAP. More importantly, targeted antibiotic therapy for VAT may improve patient outcomes and become a new paradigm for prevention or early therapy for VAP.