Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care

Al-Omari, Basem, McMeekin, Peter, Allen, A. Joy, Akram, Ahsan R., Graziadio, Sara, Suklan, Jana, Jones, William S., Lendrem, B. Clare, Winter, Amanda, Cullinan, Milo, Gray, Joanne, Dhaliwal, Kevin, Walsh, Timothy S. and Craven, Thomas H. (2021) Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care. BMC Pulmonary Medicine, 21 (1). p. 196. ISSN 1471-2466

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Official URL: https://doi.org/10.1186/s12890-021-01560-0

Abstract

Background
Ventilator-associated pneumonia (VAP) is an important diagnosis in critical care. VAP research is complicated by the lack of agreed diagnostic criteria and reference standard test criteria. Our aim was to review which reference standard tests are used to evaluate novel index tests for suspected VAP.
Methods
We conducted a comprehensive search using electronic databases and hand reference checks. The Cochrane Library, MEDLINE, CINHAL, EMBASE, and web of science were searched from 2008 until November 2018. All terms related to VAP diagnostics in the intensive treatment unit were used to conduct the search. We adopted a checklist from the critical appraisal skills programme checklist for diagnostic studies to assess the quality of the included studies.
Results
We identified 2441 records, of which 178 were selected for full-text review. Following methodological examination and quality assessment, 44 studies were included in narrative data synthesis. Thirty-two (72.7%) studies utilised a sole microbiological reference standard; the remaining 12 studies utilised a composite reference standard, nine of which included a mandatory microbiological criterion. Histopathological criteria were optional in four studies but mandatory in none.
Conclusions
Nearly all reference standards for VAP used in diagnostic test research required some microbiological confirmation of infection, with BAL culture being the most common reference standard used.

Item Type: Article
Additional Information: This study was funded by Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), https://carb-x.org, award Number 4500003353.
Uncontrolled Keywords: Critical care, Intensive care, Diagnostics, Ventilator-associated pneumonia
Subjects: A300 Clinical Medicine
B100 Anatomy, Physiology and Pathology
B800 Medical Technology
B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: Rachel Branson
Date Deposited: 13 Jul 2021 09:02
Last Modified: 13 Jul 2021 09:15
URI: http://nrl.northumbria.ac.uk/id/eprint/46662

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