VAP checklist items
| Item | Definition | |
|---|---|---|
| 1 | PaO2/FiO2 ratio* ≤300 mm Hg | Deterioration in gas exchange over past 24 h in the absence of cardiogenic pulmonary oedema or pulmonary disease |
| 2 | Sputum changes | A change in sputum characteristics, increased volume or colour changes (yellow or green) |
| 3 | CXR infiltrates | New localised or diffuse infiltrates on a single CXR (not explained by cardiogenic pulmonary oedema or pulmonary disease) |
| 4 | Inflammatory response | ≥1 of the following (in the absence of immunocompromise) |
| A.↑ Temperature | New and persistent (past 24 h) elevated body temperature ≥38°C (or >37.5°C if concurrent antipyretic medication administration) | |
| B.WCC | WCC ≤4 or ≥12 cells 109/L for 2 days | |
| C.↑ Inflammation | Elevated serum inflammatory markers: C reactive protein (>100 mg/L) or procalcitonin (>2.5 ng/L) for a single blood test | |
| 5 | Microbial growth | Microbial growth in tracheal secretions obtained by tracheal suctioning or bronchoscopy (ie, >25 neutrophils per low power field or equivalent) |
Three days after a patient is started on mechanical ventilation, are any of the following clinical characteristics present?
*PaO2/FiO2 ratio=arterial oxygen tension/fraction of inspired oxygen.
CXR, chest X-ray; VAP, ventilator-associated pneumonia; WCC, white cell count.