Nosocomial pneumonia during acute respiratory distress syndrome

The Acute Respiratory Distress Syndrome (ARDS) shares with nosocomial pneumonia aetiological, physiopathological and diagnostic properties. This report will focus on the importance of nosocomial pneumonia as a complication of ARDS and review data on prevalence, incidence and the impact of nosocomial pneumonia on outcome in patients with ARDS. Prevention strategies are imperative to protect ARDS patients for nosocomial pneumonia. The prevalence of nosocomial pneumonia seems to be at least 8%. The incidence varies largely with the study design but an estimate that every second patient with ARDS will suffer at least one episode of pneumonia during the course of mechanical ventilation, seems to reflect clinical experience and data. However, given the high incidence of nosocomial pneumonia during the course of ARDS and the impact of adequate antibiotic therapy on survival, microbiological surveillance seems to be appropriate even in the clinical routine.