Diagnosis of nonventilated hospital-acquired pneumonia: how much do we know?

Abstract:

PURPOSE OF REVIEW:To describe the current knowledge about clinical and microbiological diagnosis of nonventilated hospital-acquired pneumonia (NV-HAP). RECENT FINDINGS:NV-HAP is emerging as a new challenge for clinicians, particularly because VAP incidence has been decreasing. The clinical diagnosis of NV-HAP uses the classical clinical symptoms and signs. However standard evaluation of their accuracy and the evaluation of new criterion (e.g. lung ultrasound) must be conducted particularly in NV-HAP patients. The use of sputum must be encouraged in patients with NV-HAP, assuring its lower respiratory tract representativeness and quality. It is not clear that invasive approaches (e.g. BAL) are associated with improvements in patient-centred outcomes, and further research is needed to assure their correct indication, guaranteeing safety. Rapid diagnosis methods are promising in NV-HAP, particularly for the quick results and information about antibiotic resistance. SUMMARY:NV-HAP poses several barriers for diagnosis compared with VAP, and the available knowledge is limited. A call for further research in diagnosis of nonventilated HAP is urgent.

journal_name

Curr Opin Crit Care

authors

Ranzani OT,De Pascale G,Park M

doi

10.1097/MCC.0000000000000525

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

339-346

issue

5

eissn

1070-5295

issn

1531-7072

journal_volume

24

pub_type

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