Role of CRP, Micro- ESR and CPIS in Diagnosis of Ventilator Associated Pneumonia in Neonates at a Tertiary Care Hospital in Rajasthan.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 4
Abstract
Background: With increase in use of ventilator in NICU, Ventilator Associated Pneumonia has become a significant factor affecting the neonatal survival. Prevention with appropriate management of VAP requires early diagnosis. Methods: Hospital based observational study conducted on all children below 1 month of age kept on mechanical ventilation for at least 48 hrs & admitted in Intramural NICU (patient directly admitted in NICU) and Extramural NICU (patients referred from other hospital) . Results: Of 132 neonates who needed mechanical ventilation, 50(37.9%) developed VAP. Out of 50 cases who developed VAP, CRP was positive in 37 cases(52.1%) and 39 patients(81.2%) had CPIS >6. Sensitivity for CRP and CPIS was found to be 74% and 78% and specificity was 58.5% and 86.9% respectively while the positive predictive values were 52.1% and 81% and negative predictive values were 78.6% and 82% respectively. Significant risk factors associated with VAP were prematurity(OR=2.23), ventilation at early neonatal age(OR=2.5) and prolonged ventilation(OR=2.98). Conclusion: VAP contributes significantly to hospital acquired infection among neonates. Both CPIS and CRP were useful in screening the cases of VAP in neonates. When used in conjuction the tests were able to predict VAP even better.
Authors and Affiliations
G. S. Sengar
Keywords
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