Role of Lung Ultrasound in Early Diagnosis of Ventilator-Associated Pneumonia

Abstract

SUMMARY V entilator-associated pneumonia (VAP) remains one of the most common ICU acquired infections and is associated with greater ICU length of stay, mortality, and healthcare costs. Inadequate initial antimicrobial treatment of VAP is associated with adverse outcomes however, early adequate therapy is increasingly more difficult to achieve. So early diagnosis of VAP with simple, cost-effective, noninvasive, bedside technique is needed. Many other previous studies have found that LUS is an important mean of detecting respiratory disorders. In the present study we assess the role of lung ultrasound in early diagnosis of VAP. This study was conducted prospectively upon thirty-one patients with suspected VAP in RICU at Abbasia chest hospital in the period from 1 June 2016 until 1 April 2017. Clinical suspicion of VAP was based on the classical criteria: MV ≤ 48 h., and two or more of the following clinical criteria: temperature < 38.5_C or < 36.5_C, leukocytosis ≥ 10.5×109/L, or leukopenia < 4.5×109/L, purulent tracheal secretions. A comprehensive scan was done in six areas for each lung (superior and inferior areas in the anterior, lateral, and posterior fields using anterior and posterior axillary lines as landmarks).