VAP Incidence and Adequation to SRLF 2017 Diagnostic Among an Intensive Care Medicine Service for the Period 2022 à 2024
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Diagnostic tedst.
- Who it may be relevant to
- Registry conditions: Pneumonia Ventilator Associated. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- France
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The goal of this observational study is to to analyze respiratory samples performed in mechanically ventilated ICU patients and to assess whether the SRLF criteria for defining VAP were respected among patients admited to the Intensive care medicine at a regional hospital en France
Detailed description
Ventilator-associated pneumonia (VAP) is a lung infection that occurs after more than 48 hours of mechanical ventilation. It is of particular interest because it affects between 5-40% of ICU patients depending on the study and diagnostic criteria, with a relatively low attributable mortality (around 10%), but with increased morbidity, notably in terms of the duration of mechanical ventilation and ICU length of stay. In addition, it is the leading cause of nosocomial infection in the ICU, accounting for up to 25% of antibiotic use for hospital-acquired infections.
The diagnosis of VAP is based on clinico-radiological criteria: the appearance or worsening of a radiological pulmonary infiltrate, an inflammatory syndrome, the appearance of secretions, increased oxygen dependency and/or worsening of shock, confirmed by a positive respiratory sample.
The diagnostic challenge lies in the fact that the signs and symptoms are not pathognomonic of VAP and may be common to other conditions. On the other hand, patients may be colonized by pathogens without actually having VAP.
For this reason, scientific societies propose criteria to better target patients for whom a respiratory sample should be taken and antibiotic therapy initiated.
In 2017, the French Society of Intensive Care Medicine (SRLF) and the French Society of Anaesthesia and Intensive Care (SFAR) published recommendations on ICU-associated pneumonia, with some minor variations compared with the 2005 ATS/IDSA criteria.
Our study aims to analyze respiratory samples performed in mechanically ventilated ICU patients and to assess whether the SRLF criteria for defining VAP were respected.
Interventions
- Other Diagnostic tedst
* Radiologic signs: 2 consecutive thorax x-ray with new onset pneumonia AND * One of the following criteria * Fever \>38,3°C without any other cause * Leucocytes \< 4000/mm3 or ≥ 12000 /mm3 * AND at least two of the following * Purulent secretions * Cough or dyspnoea * Desaturation or increase in FiO2 (+20%)
Primary outcome measures
- SRLF VAP criteria [Time frame: at day 0]
Secondary outcome measures (6)
- microbial ecology in the ICU of CHSF [Time frame: at day 0]
- antibiotic consumption generated by VAP [Time frame: at day 0]
- morbidity and mortality associated with VAP [Time frame: at day 0]
- duration of antibiotic therapy for a VAP episode [Time frame: at day 0]
- characteristics of the initial antibiotic therapy [Time frame: at day 0]
- Evaluate the adequacy of the initial antibiotic therapy [Time frame: at day 0]
Eligibility criteria
Inclusion criteria
- Adults ≥ 18 years
- Hospitalization in Intensive care unit for the period between 01/01/2022 and 31/12/2024
- Intubation and mechanical ventilation for > 48h
- Positive respiratory sample
Exclusion criteria
- Decision of therapeutic limitation
- Organ donors
- Patient refuse to participate
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
France · 1 center
- Centre Hospitalier Sud Francilien — Corbeil-Essonnes
Identifiers
NCT: NCT07181824 · 2025/0025