Journal of critical care
-
Journal of critical care · Mar 2008
Randomized Controlled Trial Multicenter StudyThe value of pretest probability and modified clinical pulmonary infection score to diagnose ventilator-associated pneumonia.
The aim of the study was to assess the utility of pretest probability and modified clinical pulmonary infection score CPIS in the diagnosis of late-onset ventilator-associated pneumonia (VAP). ⋯ Pretest probability and a modified CPIS, which excludes culture results, are of limited utility in the diagnosis of late-onset VAP.
-
Journal of critical care · Mar 2008
Randomized Controlled Trial Multicenter StudyCorrelates of clinical failure in ventilator-associated pneumonia: insights from a large, randomized trial.
Our objective was to determine clinical variables measured at baseline and day 3 that may relate to failure of resolution of ventilator-associated pneumonia (VAP). ⋯ Clinical characteristics correlate with eventual outcomes in VAP. Failure of the Pao2/Fio2 ratio and fever to improve are independently associated with clinical failure. We suggest that clinicians follow these measures and consider integrating them in their decisions as to when to reevaluate persons with VAP who are not improving.
-
Journal of critical care · Mar 2008
ReviewThe impact of ventilator-associated pneumonia on the Canadian health care system.
Ventilator-associated pneumonia (VAP) is a cause of morbidity and mortality in critically ill patients. It is associated with increased health care costs and duration of mechanical ventilation. Using published data and information from public health care providers, we sought to determine the impact of VAP on the Canadian health care system. ⋯ The impact of VAP on the Canadian health care system is considerable. Eradication of this preventable nosocomial infection would save lives and conserve scarce health care resources.
-
Journal of critical care · Mar 2008
Practice GuidelineComprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: prevention.
Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in ventilated critically ill patients. ⋯ There are a growing number of evidence-based strategies for VAP prevention, which, if applied in practice, may reduce the incidence of this serious nosocomial infection.
-
Journal of critical care · Mar 2008
Practice GuidelineComprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: diagnosis and treatment.
Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in ventilated critically ill patients. Despite a large amount of research evidence, the optimal diagnostic and treatment strategies for VAP remain controversial. ⋯ We present evidence-based recommendations for the diagnosis and treatment of VAP. Implementation of these recommendations into clinical practice may lessen the morbidity and mortality of patients who develop VAP.