Table 1

VAP checklist items

1PaO2/FiO2 ratio* ≤300 mm HgDeterioration in gas exchange over past 24 h in the absence of cardiogenic pulmonary oedema or pulmonary disease
2Sputum changesA change in sputum characteristics, increased volume or colour changes (yellow or green)
3CXR infiltratesNew localised or diffuse infiltrates on a single CXR (not explained by cardiogenic pulmonary oedema or pulmonary disease)
4Inflammatory response≥1 of the following (in the absence of immunocompromise)
A.↑ TemperatureNew and persistent (past 24 h) elevated body temperature ≥38°C (or >37.5°C if concurrent antipyretic medication administration)
B.WCCWCC ≤4 or ≥12 cells 109/L for 2 days
C.↑ InflammationElevated serum inflammatory markers: C reactive protein (>100 mg/L) or procalcitonin (>2.5 ng/L) for a single blood test
5Microbial growthMicrobial 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.