Suspected but Unconfirmed VAP — What Are the Other Possibilities?

Among the 53% of patients with negative bronchoalveolar lavage results, alternative explanations for fever and for pulmonary infiltrates were established in 61% and 46%, respectively.

Chest x-ray abnormalities, leukocytosis, purulent tracheal aspirate, or fever in a mechanically ventilated patient raise suspicion for ventilator-associated pneumonia (VAP), but specificity for each of these findings is poor. Nonbacterial infections and even noninfectious inflammatory processes can mimic VAP. Recent research has demonstrated that bronchoalveolar lavage (BAL) has better sensitivity and specificity for diagnosing VAP, ranging from 75% to 85%. But how frequently is suspected VAP not confirmed by BAL, and what are the alternative diagnoses?

Researchers in the Netherlands addressed this issue in a retrospective study involving 207 patients with suspected VAP according to clinical criteria. Of these, 110 (53%) had negative BAL res…

Reviewing Author

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Suspected but Unconfirmed VAP — What Are the Other Possibilities?

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Reviewing Author