From ventilator-associated tracheobronchitis to ventilator-associated pneumonia

Ventilator-associated complications (VACs) are those complications that develop during the period of intubation. The most frequent VAC is infection. Ventilator-associated tracheobronchitis (VAT) is one of the ventilator- associated complications occurring in the critically ill patient. This infection represents an intermediate process between lower respiratory tract colonization and ventilator-associated pneumonia. Increased duration of mechanical ventilation has been reported in patients with VAT because of increased sputum production and airway inflammation. Two studies have shown a beneficial effect of antimicrobial treatment in patients with VAT. The optimal duration of antimicrobial treatment in patients with VAT should be further investigated because short courses of antimicrobials might be sufficient. Aerosolized antibiotics also need to be compared to systemic antibiotics in these patients. © 2013 Société de réanimation de langue française (SRLF) and Springer-Verlag France.