Hostname: page-component-7479d7b7d-q6k6v Total loading time: 0 Render date: 2024-07-13T18:20:57.747Z Has data issue: false hasContentIssue false

Patient Selection for Clinical Investigation of Ventilator-Associated Pneumonia: Criteria for Evaluating Diagnostic Techniques

Published online by Cambridge University Press:  21 June 2016

Susan K. Pingleton
Affiliation:
Pulmonary and Critical Care Division, University of Kansas Medical Center, Kansas City Hopital Service de Rèanimation Medicale, Broussais, Paris, France Division of Pulmonary and Critical Care Medicine, The University of Tennessee, Memphis
Jean-Yves Fagon
Affiliation:
Pulmonary and Critical Care Division, University of Kansas Medical Center, Kansas City Hopital Service de Rèanimation Medicale, Broussais, Paris, France Division of Pulmonary and Critical Care Medicine, The University of Tennessee, Memphis
Kenneth V. Leeper Jr.
Affiliation:
Pulmonary and Critical Care Division, University of Kansas Medical Center, Kansas City Hopital Service de Rèanimation Medicale, Broussais, Paris, France Division of Pulmonary and Critical Care Medicine, The University of Tennessee, Memphis

Extract

Nosocomial pneumonia in patients receiving ventilation is a common ICU occurrence. The exact frequency is not known because of the lack of specificity of the clinical diagnosis and existing standard diagnostic techniques. We have attempted to come to consensus in identifying a patient population with a clinical suspicion of nosocomial pneumonia and establishing a definition of pneumonia by which new diagnostic techniques can be compared.

Type
Proceedings of the First International Consensus Conference on the Clinical Investigation of Ventilator-Associated Pneumonia
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Johanson, WG Jr., Pierce, AK, Sanford, JR et al. Nosocomial respiratory infections with Gram-negative bacilli: the significance of colonization of the respiratory tract. Sun Intern Med. 1972;77:701706.Google ScholarPubMed
2. Torres, A, Aznar, R, Gatell, , et al. Incidence, risk, and prognosis factors of nosocomial pneumonia in ventilated patients. Am Rev Respir Dis. 1990;142:523528.Google Scholar
3. Craven, DE, Kunches, LM, Kilinsky, V, et al. Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation. Am Rev Respir Dis. 1986;133:792796.Google Scholar
4. Seidenfeld, JJ, Pohl, DE Bell, RC, et al. Incidence, site, and outcome of infections in patients with the adult respiratory distress syndrome. Am Rev Respir Dis. 1984;130:924929.Google Scholar
5. Jimenez, P, Torres, A, Rodriquez-Roisin, R, et al. Incidence and etiology of pneumonia acquired during mechanical ventilation. Crit Cure Med. 1989;17:882.CrossRefGoogle ScholarPubMed
6. Rello, J, Quintana, E, Ausine, V, et al. Incidence, etiology and outcome of nosocomial pneumonia in mechanically ventilated patients. Chest. 1991;100:439444.Google Scholar
7. Baughman, RP, Thorpe, JE, Staneck, J, et al. Use of the protected specimen brush in patients with endotracheal or tracheostomy tubes. Chest. 1987;91:233235.Google Scholar
8. Rouby, JJ, Rossignon, MD, Nicolas, MH, et al. A prospective study of protected bronchoalveolar lavage in the diagnosis of nosocomial pneumonia. Anesthesiology. 1989;71:679685.Google Scholar
9. Fagon, JY, Chastre, J, Hance, AJ, et al. Detection of nosocomial lung infection in ventilated patients: use of a protected specimen brush and quantitative culture techniques in 147 patients. Am Rev Respir Dis. 1988;138:110116.Google Scholar
10. Fagon, JY, Chastre, J, Domart, Y, et al. Nosocomial pneumonia in patients receiving continuous mechanical ventilation: prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques, Am Rev Respir Dis. 1989;139:877884.Google Scholar
11. Chastre, J, Fagon, JT, Soler, P, et al. Diagnosis of nosocomial bacterial pneumonia in intubated patients undergoing ventilation: comparison of the usefulness of bronchoalveolarlavage and the protected specimen brush. Am J Med. 1988;85:499506.Google Scholar
12. Pugin, J, Auckenthaler, R, Mili, N, et al. Diagnosis of ventilatorassociated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic blind bronchoalveolar lavage fluid. Am Rev Respir Dis. 1991;143:11211129.Google Scholar
13. Salata, RA, Lederman, MM, Shales, DM, et al. Diagnosis of nosocomial pneumonia in intubated, intensive care unit patients. Am Rev Respir Dis. 1987;135:426432.Google ScholarPubMed
14. Torres, A, De La Bellacasa, JP, Xaubet, A, et al. Diagnostic value of quantitative cultures of bronchoalveolar lavage and telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia. Am Rev Respir Dis. 1989;140:306310.Google Scholar
15. Rodriquez De Castro, E Violan, JS, Capuz, BL, et al. Reliability of the bronchoscopic protected specimen brush in the diagnosis of pneumonia in mechanically ventilated patients. Crit Cure Med. 1991;19:171176.CrossRefGoogle Scholar
16. Meduri, GU, Beals, D, Maijub, G, et al. Protected bronchoalveolar lavage: a new bronchoscopic technique to retrieve uncontaminated distal airway secretions. Am Rev Respir Dis. 1991;143:855864.Google Scholar
17. Langer, M, Cigada, M, Mandelli, M, et al. Early onset pneumonia: a multicenter study in intensive care units. Intensive Cure Med. 1987;13:342346.Google Scholar
18. Pham, LH, Brun-Buisson, C, Legrand, P, et al. Diagnosis of nosocomial pneumonia in mechanically ventilated patients: comparison of a plugged telescoping catheter with the protected specimen brush. Am Rev Respir Dis. 1991;143:10551061.Google Scholar
19. Driks, MR, Craven, DE, Celli, BR, et al. Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. N Engl J Med. 1987;317:13761382.Google Scholar
20. Chastre, J, Viau, F, Brun, P, et al. Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patients. Am Rev Respir Dis. 1984;130:924929.Google Scholar
21. Andrews, CP, Coalson, JJ, Smith, JD, et al. Diagnosis of nosocomial bacterial pneumonia in acute, diffuse lung injury. Chest. 1981;80:254258.Google Scholar