No of VAP episodes 40 Age median (range) 6.5 years (1 mo -12 yrs) Males 20 (66.5%) PRISM score (range) 13 ± 6 (0 - 34) Primary system involvement Central nervous system 9 (30) Respiratory system 6 (20) Septicemia 5 (16.6) Diabetic ketoacidosis 2 (6.6) Postoperative status 2 (6.6) Trauma 2 (6.6) Miscellaneous 4 (13.3) Multiorgan dysfunction 15 (50) Use of steroids 4 (13.3) Immunosuppressed state 2 (20) Use of H2 blockers 9 (30) Central lines 30 (100) Arterial lines 30 (100) Chest x-ray At admission Normal 21 (70) ARDS 3 (10) Others 6 (20) At initiation of MV Normal 14 (44.6) ARDS 9 (30) Others 7 (23.3) CPIS mean ±SD (range) 7.8 ± 1.5; 6 - 10