Clinical pulmonary infection score (CPIS) as a screening tool in ventilatory associated pneumonia (VAP)

Abstract

Objective: Ventilator-associated pneumonia (VAP) is one of the leading nosocomial infections in intensive care units (ICUs), causing high mortality and increased health care costs. It is known that early diagnosis and treatment reduces mortality and morbidity. In this study, we aimed to assess the efficacy of Clinical Pulmonary Infection Score (CPIS) in early diagnosis in VAP. Material and Methods: The study was performed on 43 cases. Clinical Pulmonary Infection Score parameters of each patient; body temperature, leukocyte count and morphology, volume and character of tracheal secretions, arterial oxygenation, pulmonary infiltration on chest X-ray, progression of pulmonary infiltration, microbiological culture results were recorded. Clinical Pulmonary Infection Scores were calculated at admission using the first five parameters of CPIS (basal CPIS) and after 48 hours following intubation, using seven parameters with the tracheal aspirate (TA) culture results. The patients were followed with CPIS calculated during the mechanical ventilation and with tracheal aspirate (TA) cultures obtained every three days. The patients were grouped as VAP (+) and VAP (-) in accordance with the obtained data. Results: Basal CPIS levels were similar between the two groups (p>0.05), while significant differences were detected between the 48th hour and 5th day CPIS (p<0.01). There was difference between the pre-diagnosed CPIS levels of VAP (+) and VAP (-) cases (p<0.01). Conclusion: Serial CPIS measurements can help the clinician in early diagnosis and treatment of VAP.