Examples of such conditions include trauma ...

Ventilator-associated pneumonia is usually suspected when a person develops new or progressive infiltrate on chest radiograph, leukocytosis, and purulent tracheobronchial secretions. Unfortunately, unlike pneumonia, accepted clinical criteria for pneumonia are of limited diagnostic value in the final establishment of the presence of VAP. In her death study Fabregas et al. When the results of histological analysis and culture of lung samples obtained after death were used as references, new and persistent (48 h) infiltrate on chest radiograph plus two or more of three criteria (I) fever 38. 3C, (II), leukocytosis 12 October

/ ml, and / or (III), purulent tracheobronchial secretions had a sensitivity of 69% and 75% specificity for the diagnosis of VAP (

). When all three clinical variables required for diagnosis, refused further sensitivity (23%), use one variable as a result of lower specificity (33%). The low accuracy of clinical criteria for diagnosing VAP should not be surprising, given that tracheobronchial purulent discharge is always present in patients receiving long-term mechanical ventilation and rarely caused pneumonia. In addition, systemic signs of pneumonia such as fever, tachycardia, leukocytosis and nonspecific, they may be caused by any State which produces cytokines interleukin-1, interleukin-6, tumor necrosis factor alpha and gamma interferon (,,

). Examples of such conditions include trauma, surgery, fibroproliferative buy strattera online phase HRDS, deep vein thrombosis, pulmonary embolism and pulmonary infarction. Reasonable clinical criteria for suspicion of VAP include new and permanent (48 h) or progressive radiographic infiltrate plus two of the following: temperature of 38C and 36C, blood leukocytes 10,000 cells / ml or 5000 cells / ml, purulent tracheal allocation and gas exchange degradation (

). .