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Ventilator-associated pneumonia in neonates and children: a systematic analysis of diagnostic methods and prevention

Elias Iosifidis1, Georgia Pitsava1, Emmanuel Roilides1

  • 1Infectious Disease Unit, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki Greece.

Future Microbiology
|September 27, 2018
PubMed

Insights

Diagnosing ventilator-associated pneumonia (VAP) in pediatric intensive care units (PICU) is challenging due to the lack of a gold standard. Current diagnostic methods and preventive strategies require further standardization for effective comparison.

Area of Science:

  • Pediatric Critical Care Medicine
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Ventilator-associated pneumonia (VAP) is a common and serious complication in pediatric intensive care units (PICU).
  • The absence of a definitive gold standard for VAP diagnosis complicates clinical decision-making and research.
  • Standardized diagnostic criteria and validated preventive measures are crucial for improving patient outcomes.

Purpose of the Study:

  • To systematically review diagnostic methods for VAP in pediatric patients.
  • To evaluate the effectiveness of different VAP preventive strategies in the pediatric population.
  • To highlight the challenges posed by the lack of a diagnostic gold standard.

Main Methods:

  • A systematic PubMed analysis was conducted from January 1990 to January 2017.
  • Studies focused on original, full-length articles concerning pediatric patients.
  • Inclusion criteria specified comparative diagnostic methods for VAP and preventive measures for VAP.

Main Results:

  • Out of 367 articles, 17 were analyzed for diagnosis and 16 for prevention.
  • Common diagnostic approaches included CDC criteria, clinical pulmonary index score, ventilator-associated events, and biomarkers.
  • Ventilator-care bundles demonstrated a reduction in VAP rates, and one study indicated a potential role for probiotics.

Conclusions:

  • The lack of a diagnostic gold standard hinders the comparison of current VAP diagnostic approaches.
  • Further research is needed to establish reliable diagnostic criteria for pediatric VAP.
  • Standardization of diagnostic and preventive strategies is essential for advancing VAP management in PICUs.
Abstract

Keywords:
critical illnessdiagnosispediatricspneumoniaventilator-associated

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