Figure 1

Diagram summarizing the pathogenic processes leading to ventilator-associated pneumonia (VAP; in black) and the preventative measures to combat each step (in red). Tooth brushing and chlorhexidine 2% washes help reduce oropharyngeal bacterial colonization [70]. The new generation of tracheal tubes forms the frontline barrier to reducing microaspiration by providing a better seal with the tracheal mucosa, allowing drainage of subglottic secretions and reducing colonisation of the lower respiratory tract.