Gold Standard for Diagnosis of Ventilator-Associated Pneumonia in Centers Without the Possibility of Performing Bronchoscopy: A Cross Sectional Study
Background and aim

Ventilator-associated pneumonia (VAP) is a common and very serious problem which its early diagnosis and treatment can save the lives of patients. The purpose of the present study was to determine the gold standard for the diagnosis of VAP in centers without the possibility of conducting bronchoscopy.


In this cross-sectional study, 85 patients hospitalized in the Intensive Care Unit (ICU) of Besat Hospital in Hamadan whom met the inclusion criteria were recruited. The sensitivity and specificity of components and the two criteria of the Clinical Pulmonary Infection Score (CPIS) (pulmonary infiltration, body temperature, white blood cell count, tracheal and blood cultures, and arterial partial fraction of oxygen) and the Serum Procalcitonin Level (SPCL) higher than 0.5ng/ml were calculated as the gold standard.


According to the findings of this study, 72.94% of the patients were male with an age average of 46.94 ± 18.91 years. The frequency of VAP diagnosis was 75.3% by using CPIS, and 56.47% by using SPCL. Considering the combination of the two mentioned criteria as the golden standard, the sensitivity and specificity of the CPIS criteria in the diagnosis of VAP was 97.7% and 95.1%, respectively.  The Youden test index was calculated to be 0.889.


To conclude, findings reveal that the introduced golden standard in this study is a reliable method for the diagnosis of VAP in centers without the possibility of performing bronchoscopy.

Article Type:
Research/Original Article
Journal of Critical Care Nursing, Volume:12 Issue:2, 2019
12 - 20  
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