Clinical_Pulmonary_Infection_Score_CPIS_for_Ventilator_Associated_Pneumonia_guideline v.1
Clinical Pulmonary Infection Score (CPIS) for Ventilator-Associated Pneumonia (VAP) assists in diagnosing ventilator-associated pneumonia by predicting the benefit of pulmonary cultures. CPIS variables and points: (1) Body temperature: 36.5-38.4=0, 38.5-38.9=1, ≥39.0 or ≤36.0=2; (2) White blood cell count: 4-11=0, <4 or >11=1, Either <4 or >11 plus band forms ≥500=2; (3) character of tracheal secretions (purulent or not) and quantity of tracheal aspirates: <14+=0, ≥14+=1, ≥14+ plus purulent secretions=2; (4) Oxygenation, PaO₂/FiO₂ mm Hg: >240 or ARDS=0, ≤240 and no ARDS=2; (5) Pulmonary radiography: No infiltrate=0, Diffuse or patchy infiltrate, Localized infiltrate=2; (6) Culture of tracheal aspirate specimen: Pathogenic bacteria cultured ≤1 or no growth=0, Pathogenic bacteria cultured >1+=1, Pathogenic bacteria cultured >1+ plus same pathogenic bacteria on gram stain >1+. Question about COVID-19 is for research purposes only; the answer does NOT impact results. Interpretation and interventions: Scores >6 may indicate higher likelihood of VAP and need for BAL or mini-BAL. Scores <= 6: If the clinical suspicion for VAP is LOW, do NOT culture sputum. Evaluate for other potential sources of infection. If the clinical suspicion for VAP is HIGH, perform bronchoalveolar lavage (BAL) or mini-BAL.
Clinical Pulmonary Infection Score (CPIS) for Ventilator-Associated Pneumonia (VAP) assists in diagnosing ventilator-associated pneumonia by predicting the benefit of pulmonary cultures.
CPIS for VAP can be used for adult patients (age ≥18 years) mechanically ventilated for at least 48 h with suspicion of VAP for being evaluated for possible ventilator-associated pneumonia (VAP). In the case of concomitant antibiotic use, CPIS for VAP can be used only for patients who received antibiotics for >48 h and in whom the clinical suspicion of VAP had developed during antimicrobial treatment.
1. Schurink CAM, Nieuwenhoven CAV, Jacobs JA, et al. Clinical pulmonary infection score for ventilator-associated pneumonia: accuracy and inter-observer variability. Intensive Care Med. 2004;30(2):217-224. doi:10.1007/s00134-003-2018-2 2. Fartoukh M, Maitre B, Honoré S, Cerf C, Zahar JR, Brun-Buisson C. Diagnosing pneumonia during mechanical ventilation: the clinical pulmonary infection score revisited. Am J Respir Crit Care Med. 2003;168(2):173-179. doi:10.1164/rccm.200212-1449OC 3. Shan J, Chen HL, Zhu JH. Diagnostic accuracy of clinical pulmonary infection score for ventilator-associated pneumonia: a meta-analysis. Respir Care. 2011;56(8):1087-1094. doi:10.4187/respcare.01097 4. Parks NA, Magnotti LJ, Weinberg JA, et al. Use of the clinical pulmonary infection score to guide therapy for ventilator-associated pneumonia risks antibiotic overexposure in patients with trauma. J Trauma Acute Care Surg. 2012;73(1):52-59. doi:10.1097/TA.0b013e31825ac37b 5. Zilberberg MD, Shorr AF. Ventilator-Associated Pneumonia: The Clinical Pulmonary Infection Score as a Surrogate for Diagnostics and Outcome. Clinical Infectious Diseases 2010; 51(S1):S131–S135
OBSERVATION.clinical_pulmonary_infection_score_for_ventilator_associated_pneumonia.v0
