Critical Care Medicine-Infections and Immunologic Disease>>>>>Hospital Infection Control, Hospital Acquired Infections
Question 5#

After 4 days of being intubated and sedated on a ventilator, a 62- year-old man develops fever, an increased oxygen requirement, and new infiltrates on chest X-ray. Are these findings sufficient to diagnose the patient with a probable ventilator-associated pneumonia?

A. Yes
B. No, an increase in peripheral blood white blood cell count or increase in respiratory secretions is also needed
C. No, a lower respiratory tract culture growing a potential pathogen is also needed
D. No, CT of the chest demonstrating new infiltrates is also needed

Correct Answer is C

Comment:

Correct Answer: C

Ventilator-associated pneumonia is one of several ventilator-associated events (VAE). VAEs can be difficult to diagnose, as patients are often unable to report their symptoms. Diagnostic criteria for probable ventilator-associated pneumonia include new or progressive pulmonary infiltrates on chest X-ray or CT scan, plus one or more clinical signs of infection, including increased oxygen requirement, increased respiratory secretions, increased peripheral blood white blood cell count, and fever. Diagnosis of probable ventilator-associated pneumonia is confirmed when a potential pathogen is identified in a lower respiratory tract sample.

References:

1. Kalanuria AA, Ziai W, Mirski M. Ventilator-associated pneumonia in the ICU. Criti Care. 2014;18:208.
2. Spalding MC, Cripps MW, Minshall CT. Ventilator-associated pneumonia: new definitions. Crit Care Clin. 2017;33:277-292.