Tracheostomy - Causative or Preventive for Ventilator-Associated Pneumonia?

Ventilator-associated pneumonia (VAP) is a common complication in intubated and mechanically ventilated patients. A tracheostomy has been suggested to benefit patients with prolonged need for mechanical ventilation and may protect against VAP. However, a causal relationship between tracheostomy and VAP has also been suggested. This manuscript reviews the literature regarding the (causal) relationship between tracheostomy and VAP in adult critically ill patients.