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

Lookup NU author(s): Dr Joy AllenORCiD, Dr Sara Graziadio, Dr Jana SuklanORCiD, Dr Will Jones, Dr Clare LendremORCiD, Amanda Winter



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


BackgroundVentilator-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.MethodsWe 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.ResultsWe 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.ConclusionsNearly 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.

Publication metadata

Author(s): Al-Omari B, McMeekin P, Allen AJ, Akram AR, Graziadio S, Suklan J, Jones WS, Lendrem BC, Winter A, Cullinan M, Gray J, Dhaliwal K, Walsh TS, Craven TH

Publication type: Article

Publication status: Published

Journal: BMC Pulmonary Medicine

Year: 2021

Issue: 21

Print publication date: 09/06/2021

Online publication date: 09/06/2021

Acceptance date: 02/06/2021

Date deposited: 10/06/2021

ISSN (print): 1471-2466

Publisher: BMC


DOI: 10.1186/s12890-021-01560-0


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