The role of coagulation in ventilator-associated pneumonia

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in the intensive care unit, and it is associated with prolonged hospitalization, increased health care costs, and high attributable mortality. Inflammatory changes in the pulmonary compartment as observed in acute lung injury are also often seen in VAP, and similar observations are now made regarding pulmonary coagulation changes. In the current review we will discuss the role of these coagulation changes in VAP (coagulopathy). We will discuss how mechanical ventilation affects both VAP and coagulopathy. As well as the role of anticoagulant therapies to reduce coagulopathy; from a theoretical perspective and from limited experimental research. And finally we will outline future research in this field.