Patients were excluded if they were newborns, had
a tracheostomy, had a diagnosis of pneumonia on
admission to the PICU, had been intubated longer
than 24 hours before admission to the PICU, or
declined consent. The sample comprised 96 children
who fulfilled inclusion criteria. The data were prospectively
collected from June 2005 to June 2008 onto a
standardized form. At the time of data collection,
the VAP prevention protocol in the PICU included elevation of the head of the bed 30º, interventions
to prevent peptic ulcer disease, and standardized
oral care. Site-specific algorithms for clinically or
bacteriologically defined pneumonia, including
serial chest radiographs, signs and symptoms, and
laboratory findings were followed.