Clinical Pulmonary Infection Score to Diagnose Ventilator-associated Pneumonia in Children.
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Date
2011-12
Journal Title
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Abstract
Background: There is a need to validate and suggest
easy clinical method for diagnosis of ventilator-associated
pneumonia (VAP) in developing countries.
Objectives: To validate the use of simplified Clinical
Pulmonary Infection Score (CPIS) for the diagnosis of
VAP.
Design: Prospective study.
Setting: Pediatric intensive care unit of a tertiary care
teaching hospital.
Subjects: 30 children receiving mechanical ventilation for
more than 48 hours and with simplified CPIS6.
Methods: All patients underwent flexible bronchoscopy to
obtain bronchoalveolar lavage which was analyzed
quantitatively. Colony count 104cfu/mL was considered
reference standard for definite VAP.
Results: Of the five variables used for simplified CPIS,
only patient’s temperature (P=0.013) and PaO2/ FiO2 ratio
were significant (P<0.001) to differentiate the presence of
definite VAP. Patients with definite VAP (BAL colony count
104cfu/mL) had CPIS of 8.4 while in no definite VAP
group it was 6.4 (P= 0.007). CPIS of 8 was found to have
sensitivity of 80%, specificity 80%, PPV 86.9%, NPV
70.5% and accuracy 80%. The area under Receiver
operating characteristic curve of CPIS against reference
standard was 0.81± 0.069 (P=0.001).
Conclusion: Simplified CPIS is useful in patients on
mechanical ventilation to diagnose ventilator- associated
pneumonia.
Description
Keywords
ronchoscopy, Clinical pulmonary infection score, india, Mechanical ventilation, Ventilator-associated pneumonia
Citation
Sachdev A, Chugh K, Sethi M, Gupta D, Wattal C, Menon G. Clinical Pulmonary Infection Score to Diagnose Ventilator-associated Pneumonia in Children. Indian Pediatrics. 2011 December; 48(12): 949-954.