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Published on: June 28, 2018

Clinical Pulmonary Infection Score to diagnose ventilator-associated pneumonia in children

A Sachdev1, K Chugh, M Sethi

  • 1Department of Pediatrics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110 060, India. anilcriticare@hotmail.com

Indian Pediatrics
|May 11, 2011
PubMed

Insights

A simplified Clinical Pulmonary Infection Score (CPIS) effectively diagnoses ventilator-associated pneumonia (VAP) in children on mechanical ventilation. This method offers a practical approach for VAP diagnosis in developing countries.

Area of Science:

  • Critical Care Medicine
  • Pediatric Infectious Diseases
  • Respiratory Medicine

Background:

  • Ventilator-associated pneumonia (VAP) diagnosis requires validation of simple clinical methods, especially in developing nations.
  • Current diagnostic approaches for VAP may not be easily applicable in resource-limited settings.

Purpose of the Study:

  • To validate a simplified Clinical Pulmonary Infection Score (CPIS) for diagnosing VAP in pediatric patients.
  • To assess the utility of a simplified CPIS as an accessible diagnostic tool for VAP.

Main Methods:

  • A prospective study was conducted in a pediatric intensive care unit of a tertiary care hospital.
  • 30 children on mechanical ventilation for over 48 hours with a simplified CPIS of 6 were included.
  • Flexible bronchoscopy with bronchoalveolar lavage (BAL) was performed; a colony count of = 10(4) cfu/mL in BAL defined definite VAP.

Main Results:

  • Patients with definite VAP had a mean CPIS of 8.4, compared to 6.4 in the no definite VAP group (P=0.007).
  • A simplified CPIS of 8 demonstrated 80% sensitivity, 80% specificity, and 80% accuracy for VAP diagnosis.
  • The area under the ROC curve for CPIS against the reference standard was 0.81 (P=0.001), indicating good diagnostic performance.

Conclusions:

  • The simplified CPIS is a valuable tool for diagnosing ventilator-associated pneumonia in mechanically ventilated pediatric patients.
  • This simplified scoring system offers a practical and effective method for VAP diagnosis, particularly relevant for developing countries.
Abstract

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