EN | TR
    E-ISSN: 2717-9206
    The retrospective analysis of the value of endotracheal aspirate cultures for the diagnosis of ventilator-associated pneumonia in pediatric intensive care unit
    PDF
    Cite
    Share
    Request
    Original Research
    VOLUME: 2 ISSUE: 1
    P: 13-18
    April 2015

    The retrospective analysis of the value of endotracheal aspirate cultures for the diagnosis of ventilator-associated pneumonia in pediatric intensive care unit

    J Pediatr Emerg Intensive Care Med 2015;2(1):13-18
    DOI: 10.5505/cayb.2015.44127
    Kadir Şerafettin Tekgündüz
    Mustafa Bulgan
    Merve Türkay
    1. Atatürk Üniversitesi Tıp Fakültesi Çocuk Sağlığı Ve Hastalıkları Ad, Erzurum
    2. Atatürk Üniversitesi Tip Fakültesi Çocuk Sagligi Ve Hastaliklari Ad, Erzurum
    No information available.
    No information available
    Received Date: 07.01.2015
    Accepted Date: 18.02.2015
    PDF
    Cite
    Share
    Request

    ABSTRACT

    OBJECTIVE:

    Ventilator-associated pneumonia (VAP) refers to pneumonia that develops in patients on invasive mechanical ventilation. Making an accurate diagnosis of VAP has been a challenge to clinicians. The Clinical Pulmonary Infection Score (CPIS) was developed to serve as a surrogate tool to facilitate the diagnosis of ventilator-associated pneumonia. The aim of this study was to assess the value of the combination of endotracheal aspirate (ETA) culture and CPIS.

    METHODS:

    Seventeen episodes of culture-positive endotracheal aspirates were analysed retrospectively in 9 mechanically ventilated children. VAP was diagnosed according to the Center for Disease Control (CDC) criteria. CPIS scores were calculated by adding ETA culture results.

    RESULTS:

    There were a total of 33 patients in the study period. The median age at the admission was There were a total of 33 patients in the study period. The median age at the admission was 3,4±2.1 years. 22 (67%) of the patients were male. Fever was the first symptom in 84% and meningococcemic rashes were peresent at the admission in 97% of the patients. Lumbar puncture was performed in 45% of the patients and 7 (21%) of them had meningitis with meningococcemia. N. meningitidis was cultured from 7 blood and 2 cerebrospinal fluid samples. An average of 60 mL/kg fluid bolus was given to 93% of the patients within the first hour of hospital admission. Dopamine, dobutamine, and epinephrine were given to patients who required inotropic and vasopressor infusions (54.5%, 27.2%, 12.1% of the patients, respectively). Fifty-eight percent of the patients received steroid therapy and 12% of them received heparin infusion for disseminated intravascular coagulation and purpura fulminans. The mean length of PICU stay was 6 days (1 to 29 days) and the overall mortality rate was 21% (7 patients).

    CONCLUSION:

    As a single tool, ETA cultures do not appear to distinguish between infection and colonization. Our results suggest that the ETA-CPIS had a clinically acceptable performance, and it can be a helpful screening tool for VAP diagnosis. However, prospective large studies are required to determine the clinical value of ETA-CPIS.

    Keywords: Intensive care, pneumonia, ventilators, mechanical

    References

    2024 ©️ Galenos Publishing House