Diagnostic criteria for pneumonia ventilator associated: an integrative review
Critérios diagnósticos de pneumonia associada à ventilação mecânica: uma revisão integrativa
Palavras-chave:
Pneumonia, ventilator-associated, Diagnosis, Pneumonia, Healthcare-associated pneumonia, Intensive care unitsResumo
Ventilator-associated pneumonia (VAP) develops in patients on mechanical ventilation for more than 48 hours and is considered a serious infection of the lung parenchyma, responsible for high mortality and morbidity in intensive care units (ICU). The absence of a gold standard in its diagnosis, with inconsistent and insensitive criteria, makes the number of diagnosed cases questionable. The objective of this study was to identify the diagnostic criteria for VAP available in the scientific literature, as well as to describe and determine their frequency. A search was carried out in the Cochrane, Embase, Lilacs and Pubmed databases in June 2020. 60 studies on the topic were selected and 323 diagnostic criteria were identified. Microbiological and clinical diagnostic criteria were the most frequent (37% and 33%, respectively). Bronchoalveolar lavage (BAL) and changes in body temperature were the most cited characteristics in the studies analyzed. This study made it possible to identify a significant number of guiding characteristics of VAP, showing how challenging it is to diagnose. Exams with more objective approaches, such as LBA, still seem to be the safest and most accessible path to diagnosis for most patients to date.
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