Re-intubation: Re-intubation is associated with a higher risk of VAP due to higher rates of aspiration16. Adequate ICU staffing should be maintained to minimize unplanned extubations necessitating re-intubation17, and planned extubations should be carefully considered. As clinicians postulate weaning, they must be mindful of and balance the risks associated with re-intubation and the cumulative time of mechanical ventilation