The clinical diagnosis of pneumonia in ventilated patients is difficult. The usual criteria include the following:
1. new or progressive chest radiograph infiltrates;
3. leukocytosis or leukopenia;
4. new or increasing purulent tracheobronchial secretions.
Using six variables may increase the prognostic power (Niederman. etal; 1994). Mechanically ventilated patients are rapidly colonized with Gram-negative organisms, making interpretation of tracheobronchial cultures difficult. Non-infectious causes of chest radiograph infiltrates are common and there are many causes of fever other than pneumonia (Meduri 1990). Thus clinical criteria alone are insufficient to diagnose ventilator-associated pneumonia, with as few as one-third of clinical diagnoses being confirmed.
Was this article helpful?