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تعداد آیتم قابل مشاهده باقیمانده : -33 مورد

Diagnostic criteria for ventilator-associated tracheobronchitis (VAT) in intubated pediatric patients

Diagnostic criteria for ventilator-associated tracheobronchitis (VAT) in intubated pediatric patients
The diagnosis of VAT requires all 4 of the following criteria
  1. Patient has been intubated for at least 48 hours
  1. At least 2 of the following signs of respiratory tract infection with no other recognized cause:
    • Fever >38°C or hypothermia <36°C
    • Cough
    • New or increased sputum production/increased need for endotracheal suctioning
    • Rhonchi and/or wheezing
    • Respiratory distress (or in neonates, apnea, and/or bradycardia)
  1. No radiographic evidence of pneumonia
  1. A positive culture obtained by deep tracheal aspirate or bronchoscopy
Most studies evaluating VAT in children used the above or similar diagnostic criteria. However, these diagnostic criteria have important limitations. For example, most of the findings listed in criterion number 2 are nonspecific (eg, fever, rhonchi/wheezing), subjective (eg, increased secretions), and/or challenging to assess in intubated and sedated patients (eg, cough, respiratory distress). When applying these criteria, clinicians should be aware that VAT lies on a continuum between bacterial colonization of the endotracheal tube and invasive lower respiratory tract infection (ie, VAP). Determining when the patient reaches the threshold for treatment requires clinical judgment. For additional details, refer to UpToDate topic on tracheobronchitis associated with artificial airways in children.
VAP: ventilator-associated pneumonia.
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