The place of analysis of organ dysfunction in relation to the diagnosis of nosocomial pneumonia in intensive care is not yet defined.
New onset of pulmonary infiltrates, fever, and an increase in white blood cell (WBC) count accompanied by purulent tracheal secretions are clinically indicative of hospital-associated pneumonia (HAP). The low specificity and sensibility of diagnostic tests for HAP, however, tends to result in an extremely high incidence of missed diagnoses and may lay to high mortality. The place of analysis of organ dysfunction in relation to the diagnosis of nosocomial pneumonia in intensive care is not yet defined, because early organ dysfunction may be the first symptoms noted by clinicians.
Study Type
OBSERVATIONAL
Enrollment
298
Centre Chirurgical Marie Lannelongue
Le Plessis-Robinson, France
Area under the ROC curve of the CPIS score
The CPIS score is based on six variables: * Fever * Leukocytosis * Tracheal aspirates * Oxygenation * Radiographic infiltrates * Cult of tracheal aspirates
Time frame: the previous 12 hours up to performance of pulmonary bacteriological samples
Area under the ROC curve of increased use of catecholamine and their positive and negative predictive values
Sensibility (%) and specificity (%) increased use of catecholamine
Time frame: the previous 12 hours up to performance of pulmonary bacteriological samples
Area under the ROC curve of increased need a volemic expansion and their positive and negative predictive values
Sensibility (%) and specificity (%) increased need a volemic expansion
Time frame: the previous 12 hours up to performance of pulmonary bacteriological samples
Area under the ROC curve of depletion inability and their positive and negative predictive values
Sensibility (%) and specificity (%) of depletion inability
Time frame: the previous 12 hours up to performance of pulmonary bacteriological samples
Area under the ROC curve of confusion and their positive and negative predictive values
Sensibility (%) and specificity (%) of confusion
Time frame: the previous 12 hours up to performance of pulmonary bacteriological samples
Area under the ROC curve of hepatic perturbation and their positive and negative predictive values
Sensibility (%) and specificity (%) of hepatic perturbation defined by increased gamma-glutamyl transpeptidase (CGT) and or alkaline phosphatase \>1,5 N and or bilirubin \>1,5 N or aminotransferase (AST or ALT \>2 N)
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Time frame: the previous 12 hours up to performance of pulmonary bacteriological samples
Mortality
Mortality during ICU stay
Time frame: 28 days