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Hospital-acquired pneumonia (HAPs), including ventilator-associated pneumonia (VAP), often start in the oral cavity.1,2 Bacteria, including dental plaque biofilm, can colonize in the oropharyngeal area,3 and these pathogens can be aspirated into the lungs, causing infection.4 VAP is the most common infectious complication among ICU patients and accounts for over 47% of all infections.5 Non-vent patients with conditions including dysphagia, stroke, COPD and malignancy are also at risk for HAP.6, 7
VAP CONSEQUENCES:
- Mortality rate of up to 76%.8
- Mean hospital costs can reach $150,000 per episode.5
- Mean length of stay can reach 23 days.5
- 9.6 additional days on the vent, 6.1 extra days in the ICU and 11.5 more days in the hospital.6
Image Description:
Dental plaque biofilm: Normal oral flora and their glue-like properties attach exogenous pathogens to the surface of the teeth, forming a multi-organism biofilm. This biofilm can fragment and travel in oral secretions. If aspirated, it may lead to infection (pneumonia).
In addition to increased infection risk, the biofilm grows thicker and calcifies in the alveolus, rendering gases exchange ineffective. Subsequently, under mechanical ventilation, the biofilm can potentially attach and accumulate in the endotrach lumen, increasing airway resistance and Work of Breathing (WOB)9. |
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