• Pediatr Crit Care Me · May 2005

    Review

    Defining pneumonia in critically ill infants and children.

    • Joanne M Langley and John S Bradley.
    • Clinical Trials Research Centre, IWK Health Center, and the Department of Pediatrics, Dalhousie University, Halifax, Canada.
    • Pediatr Crit Care Me. 2005 May 1;6(3 Suppl):S9-S13.

    ObjectiveTo define pneumonia in critically ill children in the intensive care unit setting for surveillance of infection and for the design, conduct, and evaluation of clinical trials in the prevention and therapy of lower respiratory tract infections in this population.DesignSummary of the literature with review and consensus by experts in the field.ResultsA variety of diagnostic criteria from the medical literature, professional societies, and governmental health agencies and regulators were identified. Very few of these diagnostic criteria have been validated for use in children. We propose definitions for definite, possible, and probable pneumonia that build on identified definitions in the literature and use combinations of symptoms, signs, and laboratory criteria. Gaps in knowledge were identified.ConclusionsAlthough pneumonia is one of the most common diagnoses in critically ill children, there have been few studies validating diagnostic criteria. Definitions for definite, probable, and possible community-acquired pneumonia and nosocomial pneumonia were achieved by consensus of experts based on guidelines from governmental agencies, professional organizations, and published literature. Future research should determine the utility of these definitions in the critically ill child and adapt them accordingly.

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