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Eliminating Ventilator-Associated Pneumonia in Critical Care
6/18/2005 6:27:44 AM
User Comments on Eliminating Ventilator-Associated Pneumonia in Critical Care
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Judith Menard
Total Posts: 1
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Re: Eliminating Ventilator-Associated Pneumonia in Critical Care
5/2/2006 1:57:08 PM
The definition of VAP as supplied on your web site states VAP is defined as nosocomial pneumonia in a patient on mechanical ventilatory support for greater than or equal to 48 hours. This implies the patient must be on mechanical ventilation for 48 hours before you can count a VAP. Other definitions (CDC) do not mention a time frame. I believe the 48 hours applies to the nosocomial infection not the time on the vent. Can someone please clarify this.
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Vicki Spuhler
Total Posts: 22
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Re: Eliminating Ventilator-Associated Pneumonia in Critical Care
5/2/2006 7:25:31 PM
The definition below in quotes was taken from the CDC website. This is the definition that was used when developing the guidelines for the 100K lives campaign. The real intent of the guideline is to provide a process for improvement not for diagnosis. Each institution may have their process for identifying VAP. In order for you to see progress you should really continue to use the current definition used by your ID department. If that definition differes from the one IHI has stated, but it is the definition you have used consistently, continue to use it so you will see improvement in your outcomes.
"Ventilator-associated pneumonia (VAP) is pneumonia in patients who have been on mechanical ventilation for >48 hours. VAP is most accurately diagnosed by quantitative culture and microscopic examination of lower respiratory tract secretions, which are best obtained by bronchoscopically directed techniques such as the protected specimen brush and bronchoalveolar lavage. These techniques have acceptable repeatability, and interpretation of results is unaffected by antibiotics administered concurrently for infection at extrapulmonary sites as long as antimicrobial therapy has not been changed for <72 hours before bronchoscopy.
In conclusion, in the absence of gold standard criteria for the diagnosis of VAP, the diagnostic test of choice is quantitative culture and microscopic examination of lower respiratory tract secretions"
Hope this is helpful to you.
Vicki Spuhler
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