Nosocomial Infections and Ventilator-Associated Pneumonia (VAP) in Non-Invasive Ventilatory Support

Dear Colleagues,

Nosocomial infections and ventilator-associated pneumonia (VAP) is the most frequent infectious complication in patients on invasive mechanical ventilation. Over the last two decades, the role of non-invasive ventilation approaches (non-invasive ventilation (NIV) and nasal high-flow oxygen (NHF)) in preventing VAP has been clearly demonstrated in epidemiological studies, and its recommendation is well-established. However, there are some factors prior to and during NIV, that are not yet fully understood, which may predispose patients to a higher risk of VAP if endotracheal intubation is delayed in NIV failure and increase hospital mortality. Several possible mechanisms described are considered, such prior upper airway colonization, higher prevalence of patient self-inflicted lung injury (P-SILI), ventilatory mode (continuous positive airway pressure (CPAP), bilevel positive airway pressure (BIPAP), frequency of combining non-invasive ventilation (NIV) and (NHF) or home NIV.

This Special Issue allows to hospital health professionals to present and analyze data from clinical and microbiological studies that help us understand and prevent the increased frequency of VAP in patients with NIV–NHF failure requiring endotracheal intubation and to establish more efficacy nosocomial infections in high risk patients (immunocompromised, elderly, previous colonization).

Dr. Antonio Matías Esquìnas
Guest Editor

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