DISCUSSION
The VAP rates in our study were lower than many reported
in the research literature. The VAP rates in the
trauma population range from 17.2% to 43% 35,36; when
brain injury is present, rates increase substantially from
28% to 80%. 32,36-39 Although the difference in VAP rates between
cases and controls in our study was not statistically
significant, we were unable to find other studies that directly
compared VAP rates between trauma patients with
and without brain injury receiving standardized care in
the same ICU. Most studies report VAP rates solely among
trauma patients or specifically among patients who had
sustained severe TBI. In our study, we were able to directly
compare VAP rates and risk factors among patients
receiving the same standardized VAP prevention efforts,
which included key elements of the VAP bundle, and determine
whether the presence of concomitant brain injury
influenced VAP rates. The fact that our VAP rates among
cases and controls were similar and lower than those
reported in the literature may be reflective of the VAP