Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Ventilator associated pneumonia (VAP) in children: a diagnostic challenge
1Pediatric Intensive Care Unit, Medical Faculty, Hippokration General Hospital, 54642 Thessaloniki, Greece
2Infectious Disease Unit, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, 54642 Thessaloniki, Greece
33rd Pediatric Department, Medical Faculty, Aristoteles University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
DOI: 10.22514/sv.2023.050 Vol.19,Issue 4,July 2023 pp.6-19
Submitted: 31 March 2022 Accepted: 18 May 2022
Published: 08 July 2023
*Corresponding Author(s): Serafeia Kalamitsou E-mail: serfkal@yahoo.gr
Respiratory support in critically ill children is crucial and often mechanical ventilation (MV) is needed for lifesaving intervention. MV can lead to complications with, ventilator associated pneumonia (VAP) being one of the most serious and has been associated with prolonged length of mechanical ventilation (LOV) and length of stay in hospital (LOS), morbidity and mortality. Despite the importance of VAP, the definition (both clinically and epidemiologically) is limited. Some of the criteria used for the definition of VAP are subjective. In addition, the use of different diagnostic parameters in VAP definition has resulted in major limitations in terms of surveillance and prevention. Pediatric VAP as well as other pediatric medical conditions are based on a number of different criteria in adult studies. The various challenges and different approaches to defining VAP, especially in children, are obvious in the most recent literature. During the last decade, there has been an attempt to overcome some of these previous challenges and limitations. With this historical context in mind, a new surveillance definition of VAP was proposed for adults in 2013, ventilator-associated events (VAEs). In 2020, the pediatric definition of VAE (pedVAE) was introduced by centers for disease control and prevention (CDC) with adjusted criteria for the pediatric population. One of the clinical definitions, clinical pulmonary infection score (CPIS), has been modified (mCPIS) and adjusted to pediatric VAP. This narrative review describes the different definitions that are currently available for epidemiological as well as clinical purposes. We target to summarize the differences and similarities in all proposed definitions in order to help clinicians and investigators better evaluate this complicated medical condition that presents in their patients.
Pediatric ventilator-associated pneumonia (VAP); Pediatric ventilator-associated event (VAE); PedVAE; Ventilator-associated condition (VAC); Diagnostic criteria; PICU
Serafeia Kalamitsou,Asimina Violaki,Elias Iosifidis,Vasiliki Avramidou,Peristera-Eleni Mantzafleri,Evangelia Karaiskou,Nikolaos Karantaglis,Maria Sdougka. Ventilator associated pneumonia (VAP) in children: a diagnostic challenge. Signa Vitae. 2023. 19(4);6-19.
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