下列哪位病人發生醫院內肺炎（HAP）的風險最高？
Which of the following patients is at highest risk for developing hospital-acquired pneumonia?
- AA patient with a broken ankle踝關節骨折的病人
- BA patient who is ambulatory能下床走動的病人
- CA patient on a mechanical ventilator✓ 正解接受機械通氣的病人
- DA patient with a mild skin infection患有輕微皮膚感染的病人
醫院內肺炎（HAP）的風險與侵入性醫療設備直接相關。機械通氣（Mechanical ventilator）病人因氣管內管（Endotracheal tube）的存在，繞過了咽喉的自然防禦機制（如咳嗽反射、纖毛運動），使得口腔與胃部的細菌極易進入肺部，導致呼吸器相關肺炎（VAP）。這是 ICU 中最嚴重的感染併發症之一，風險遠高於其他非侵入性狀況。
Hospital-acquired pneumonia (HAP) risk is directly related to invasive medical devices. Clients receiving mechanical ventilation, due to the presence of an endotracheal tube, bypass the natural defense mechanisms of the pharynx (such as the cough reflex and ciliary motion), allowing oral and gastric bacteria to easily enter the lungs and cause ventilator-associated pneumonia (VAP). This is one of the most serious infectious complications in the ICU, with a much higher risk than other non-invasive conditions.
美國醫院針對 VAP 有嚴格的「Ventilator Bundle」防護措施，包括抬高床頭（Head of bed elevation）、口腔護理（Chlorhexidine mouth care）及每日評估脫離呼吸器可能性（Sedation vacation）。