Trauma-associated pneumonia in adult ventilated patients.

Abstract:

BACKGROUND:The clinical pulmonary infection score (CPIS) and bronchoalveolar lavage (BAL) are 2 tools that have been validated to diagnose pneumonia in critically ill patients. However, the role of the CPIS in diagnosing trauma-associated pneumonia (TAP) remains in question. METHODS:This prospective observational study included all trauma patients who were ventilated for longer than 48 hours from September 2008 to September 2009. The CPIS and quantitative culture results from the BAL were collected and used to define pneumonia. RESULTS:A total of 162 patients were identified. In all, 58 (35.8%) and 104 (64.2%) had a CPIS greater than 5 and a CPIS of 5 or less, respectively. There were 95 (58.6%) patients who had a BAL completed regardless of CPIS. There were 65 patients who met the bacteriologic definition of pneumonia (≥10(4) colonies/mL), for an overall TAP incidence of 40.1%. CONCLUSIONS:The CPIS is unreliable as a clinical tool to predict a positive BAL at 10(4) or 10(5) or higher threshold. Therefore, BAL should be used for the diagnosis of TAP based on clinical rationale and not the CPIS.

journal_name

Am J Surg

authors

Patel CB,Gillespie TL,Goslar PW,Sindhwani M,Petersen SR

doi

10.1016/j.amjsurg.2010.10.010

subject

Has Abstract

pub_date

2011-07-01 00:00:00

pages

66-70

issue

1

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(11)00029-8

journal_volume

202

pub_type

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