Clinical pulmonary infection score to diagnose ventilator-associated pneumonia in children

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 P...

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Published in:Indian pediatrics 2011-12, Vol.48 (12), p.949-954
Main Authors: Sachdev, Anil, Chugh, K., Sethi, M., Gupta, D., Wattal, C., Menon, G.
Format: Article
Language:English
Subjects:
Bronchoscopy
Child
Child, Preschool
Female
Humans
India
Infant
Male
Maternal and Child Health
Medicine
Medicine & Public Health
Pediatric Surgery
Pediatrics
Pneumonia, Ventilator-Associated - diagnosis
Pneumonia, Ventilator-Associated - microbiology
Prospective Studies
Research Paper
Severity of Illness Index
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cited_by cdi_FETCH-LOGICAL-c386t-c476229be26025a630e9615ac7c9de6a36ad59b3691b406017b4bf95e079bb0c3
cites cdi_FETCH-LOGICAL-c386t-c476229be26025a630e9615ac7c9de6a36ad59b3691b406017b4bf95e079bb0c3
container_end_page 954
container_issue 12
container_start_page 949
container_title Indian pediatrics
container_volume 48
creator Sachdev, Anil
Chugh, K.
Sethi, M.
Gupta, D.
Wattal, C.
Menon, G.
description 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 CPIS≥6. Methods All patients underwent flexible bronchoscopy to obtain bronchoalveolar lavage which was analyzed quantitatively. Colony count ≥10 4 cfu/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 PaO 2 /FiO 2 ratio were significant ( P
doi_str_mv 10.1007/s13312-011-0154-2
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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 CPIS≥6. Methods All patients underwent flexible bronchoscopy to obtain bronchoalveolar lavage which was analyzed quantitatively. Colony count ≥10 4 cfu/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 PaO 2 /FiO 2 ratio were significant ( P &lt;0.001) to differentiate the presence of definite VAP. Patients with definite VAP (BAL colony count ≥10 4 cfu/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><identifier>ISSN: 0019-6061</identifier><identifier>EISSN: 0974-7559</identifier><identifier>DOI: 10.1007/s13312-011-0154-2</identifier><identifier>PMID: 21555799</identifier><language>eng</language><publisher>India: Springer-Verlag</publisher><subject>Bronchoscopy ; Child ; Child, Preschool ; Female ; Humans ; India ; Infant ; Male ; Maternal and Child Health ; Medicine ; Medicine &amp; Public Health ; Pediatric Surgery ; Pediatrics ; Pneumonia, Ventilator-Associated - diagnosis ; Pneumonia, Ventilator-Associated - microbiology ; Prospective Studies ; Research Paper ; Severity of Illness Index</subject><ispartof>Indian pediatrics, 2011-12, Vol.48 (12), p.949-954</ispartof><rights>Indian Academy of Pediatrics 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-c476229be26025a630e9615ac7c9de6a36ad59b3691b406017b4bf95e079bb0c3</citedby><cites>FETCH-LOGICAL-c386t-c476229be26025a630e9615ac7c9de6a36ad59b3691b406017b4bf95e079bb0c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21555799$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sachdev, Anil</creatorcontrib><creatorcontrib>Chugh, K.</creatorcontrib><creatorcontrib>Sethi, M.</creatorcontrib><creatorcontrib>Gupta, D.</creatorcontrib><creatorcontrib>Wattal, C.</creatorcontrib><creatorcontrib>Menon, G.</creatorcontrib><title>Clinical pulmonary infection score to diagnose ventilator-associated pneumonia in children</title><title>Indian pediatrics</title><addtitle>Indian Pediatr</addtitle><addtitle>Indian Pediatr</addtitle><description>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 CPIS≥6. Methods All patients underwent flexible bronchoscopy to obtain bronchoalveolar lavage which was analyzed quantitatively. Colony count ≥10 4 cfu/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 PaO 2 /FiO 2 ratio were significant ( P &lt;0.001) to differentiate the presence of definite VAP. Patients with definite VAP (BAL colony count ≥10 4 cfu/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). 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source Springer Nature; Alma/SFX Local Collection
subjects Bronchoscopy
Child
Child, Preschool
Female
Humans
India
Infant
Male
Maternal and Child Health
Medicine
Medicine & Public Health
Pediatric Surgery
Pediatrics
Pneumonia, Ventilator-Associated - diagnosis
Pneumonia, Ventilator-Associated - microbiology
Prospective Studies
Research Paper
Severity of Illness Index
title Clinical pulmonary infection score to diagnose ventilator-associated pneumonia in children
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