Reaching the correct diagnosis of ventilator-associated pneumonia (VAP) can be a considerable challenge for physicians. Many conditions seem similar to VAP, say researchers from Chi Mei Medical Center in Tainan, Taiwan. Moreover, the conventional definition of VAP relies on clinical, radiologic, and microbiologic findings that may be interpreted differently by different clinicians.
In 2013, the CDC National Healthcare Safety Network developed a novel approach to surveillance for ventilator-associated events (VAEs) to better improve the objectivity and reproducibility of VAP surveillance. The new algorithm defines VAEs with a combination of “objective, streamlined, and potentially automatable criteria,” including deterioration in respiratory status after a period of stability or improvement on the ventilator.
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But does the new method outperform the old? In their retrospective study, which analyzed 165 episodes of VAP, the researchers compared the new method with conventional paradigms and found novel VAE surveillance detected only 33.3% of conventional VAP cases. This study suggests that the concordance between the new algorithm and conventional VAP surveillance is poor, the researchers said. They advise more studies to further validate VAE surveillance.
Sources
Chang HC, Chen CM, Kung SC, Wang CM, Liu WL, Lai CC. Am J Infect Control. 2015;43(2):133-136.
doi: 10.1016/j.ajic.2014.10.029.
Centers for Disease Control and Prevention. Ventilator-Associated Event (VAE) Protocol. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2015.
