Academic Journal
2420. Analysis of Diagnostic Criteria for ECMO-Associated Pneumonia
| العنوان: | 2420. Analysis of Diagnostic Criteria for ECMO-Associated Pneumonia |
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| المؤلفون: | England, Julie, Xie, Rongbing, Marshall, Tammy, Kirklin, James, Blood, Peggy, Wille, Keith, Gongora, Enrique, Sharp, Brandon, Nellore, Anoma, Lee, Rachael A, Walker, Jeremey |
| المصدر: | Open Forum Infectious Diseases ; volume 10, issue Supplement_2 ; ISSN 2328-8957 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Infectious Diseases, Oncology |
| الوصف: | Background Ventilator-associated pneumonia (VAP) is a well-established cause of morbidity and mortality in critically ill patients, but diagnostic criteria exclude patients on extracorporeal membrane oxygenation (ECMO). Despite this, VAP has been used to approximate pneumonia in patients on ECMO for study purposes (Figure 1). An adequate definition to recognize and prevent nosocomial pneumonia in this population is needed. Our institution began looking at a set of diagnostic criteria for EAP (ECMO-Associated Pneumonia, Figure 2). We performed a retrospective analysis to test the validity of VAP and our new EAP definition as diagnostic criteria for pneumonia in ECMO patients.Figure 1.Criteria for Probable VAP. Simplified from NHSN criteria. VAC=ventilator-associated condition. iVAC=infection-related ventilator-associated condition. VAP=ventilator-associated pneumonia.Figure 2.Proposed diagnostic criteria for ECMO-associated pneumonia (EAP) Methods Our center maintains a database of clinical parameters for patients on ECMO, which includes outcomes of interest verified in real time. Patient charts coded as having an outcome of pneumonia from 2018 to 2021 were pulled and independently adjudicated to determine if they met our inclusion criteria (Figure 3). 20 patients were identified as having at least one event. We observed their stay on ECMO up to 30 days. We calculated the established VAP criteria (Figure 1) and our proposed EAP criteria (Figure 2) daily. Dates of clinical pneumonia were time of positive culture and subsequent 5 days.Figure 3.Selection process for study population. BAL=bronchoalveolar lavage Results 85% of patients were on VV ECMO and 50% patients with SARS-CoV-2 (Table 1). In 20 patients with clinically diagnosed, culture confirmed pneumonia, only 1% of patients met criteria for Probable VAP (sensitivity 4%, Table 2). Probable EAP Definition 2 was the most sensitive model for predicting clinical pneumonia (sensitivity 91.1%), followed distantly by the Confirmed EAP model (sensitivity ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1093/ofid/ofad500.2040 |
| الاتاحة: | http://dx.doi.org/10.1093/ofid/ofad500.2040 https://academic.oup.com/ofid/article-pdf/10/Supplement_2/ofad500.2040/53762122/ofad500.2040.pdf |
| Rights: | https://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.D6677C68 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/ofid/ofad500.2040 |
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