Controversies in ventilator-associated pneumonia

Seminars in Respiratory and Critical Care Medicine
Alain CombesJ Chastre

Abstract

Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection among patients receiving mechanical ventilation. Consensus, however, on the most appropriate diagnostic strategy for patients clinically suspected of having developed VAP has yet to be reached. Concern about the inaccuracy of clinical approaches to VAP recognition and potential for excessive use of antibiotics in the ICU had led numerous investigators to postulate that quantitative cultures of specimens obtained with bronchoscopic or nonbronchoscopic techniques, such as bronchoalveolar lavage (BAL) and/or protected specimen brush (PSB), could improve identification of patients with true VAP and facilitate decisions whether to treat. Other than decision-analysis studies and one retrospective study, only five trials assessed the impact of such a quantitative bacteriological strategy on antibiotic use and outcome of patients suspected of VAP using a randomized scheme. In one study, the invasive management strategy was significantly associated with earlier attenuation of organ dysfunction and less antibiotic exposure, but the four other trials could not replicate these positive findings, including a large Canadian study that enro...Continue Reading

Citations

Jun 16, 2011·Neurocritical Care·Petri KuusinenHannu Syrjala
May 21, 2014·Surgical Infections·Christopher A GuidryRobert G Sawyer
Sep 23, 2014·Scandinavian Journal of Infectious Diseases·Rik J SchoemakersDennis C J J Bergmans
Mar 19, 2014·American Journal of Infection Control·Rudy TedjaDavid van Duin
Jul 16, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andre C KalilJan L Brozek
Nov 3, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Vani VenkatachalamDouglas F Willson
Nov 23, 2017·ERJ Open Research·Gennaro De PascaleIgnacio Martín-Loeches
May 23, 2012·Hospital Practice·Jean-Louis Trouillet
Dec 28, 2012·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Anil SachdevGeetha R Menon

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bacterial Pneumonia (ASM)

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Bacterial Pneumonia

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Related Papers

International Journal of Health Care Quality Assurance
Fardin YousefshahiAtabak Najafi
Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Susan E CoffinDeborah S Yokoe
American Journal of Respiratory and Critical Care Medicine
J Chastre, Jean-Yves Fagon
American Journal of Respiratory and Critical Care Medicine
American Thoracic Society, Infectious Diseases Society of America
© 2021 Meta ULC. All rights reserved