Ventilator-associated pneumonia in neonates and children: a systematic analysis of diagnostic methods and prevention.

Elias Iosifidis, Georgia Pitsava, Emmanuel Roilides

Journal: Future microbiology 2019;13():1431-1446

PMID: 30256161

Abstract

AIM

While ventilator-associated pneumonia (VAP) remains frequent in Pediatric ICU, there is no gold standard for diagnosis.

METHODOLOGY

We conducted a systematic PUBMED analysis (January 1990-January 2017) searching original, full-length studies addressing only pediatric patients; for VAP diagnosis, only those comparing different diagnostic methods and for VAP prevention those implementing preventive measures.

RESULTS

Among 367 articles, 17 and 16 were analyzed for diagnosis and prevention, respectively. For diagnosis, 13 studies used CDC criteria; whereas, 14 assessed algorithms: clinical pulmonary index score, ventilator-associated events and biomarkers. Among five randomized trials assessing preventive strategies one found a role of probiotics. Ventilator-care bundles reduced VAP rates.

CONCLUSION

Absence of diagnostic gold standard impedes comparison of current approaches and preventive strategies.

Address: Infectious Disease Unit, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki Greece.

DOI: 10.2217/fmb-2018-0108

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MeSH Terms: Humans, Infant, Infant, Newborn, Intensive Care Units, Pneumonia, Ventilator-Associated, Probiotics, Randomized Controlled Trials as Topic, Ventilators, Mechanical