Baughman Robert P
Department of Internal Medicine, University of Cincinnati Medical Center, Ohio, USA.
Curr Opin Crit Care. 2003 Oct;9(5):397-402. doi: 10.1097/00075198-200310000-00010.
This review examines the various techniques used to diagnose ventilator-associated pneumonia. The ideal diagnostic test not only helps the clinician to recognize whether pneumonia is present, but also to influence clinical outcome.
Several studies have suggested that the clinical pulmonary infection score can be used to detect the onset of ventilator associated pneumonia. Serial clinical pulmonary infection scores have also been useful in helping to decide when to stop therapy. Semiquantitative culture methods have been used for nonbronchoscopic and bronchoscopic samples. Adequate initial empiric therapy for those organisms identified in these samples has been associated with improved survival. This supports the use of these culture techniques to diagnose patients with ventilator-associated pneumonia.
Diagnostic testing for ventilator-associated pneumonia can identify those patients at risk for a poor clinical outcome.
本综述探讨用于诊断呼吸机相关性肺炎的各种技术。理想的诊断测试不仅有助于临床医生识别是否存在肺炎，还能影响临床结局。
多项研究表明，临床肺部感染评分可用于检测呼吸机相关性肺炎的发病。连续的临床肺部感染评分在帮助决定何时停止治疗方面也很有用。半定量培养方法已用于非支气管镜和支气管镜样本。对这些样本中鉴定出的病原体进行充分的初始经验性治疗与生存率提高相关。这支持使用这些培养技术来诊断呼吸机相关性肺炎患者。
呼吸机相关性肺炎的诊断测试可以识别那些临床结局不佳风险较高的患者。
