HAP and VAP not HCAP!

The new guideline by IDSA published’ Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society.” There are some answered questions that previously we were practicing based on them.

  1. I. Should Patients With Suspected VAP Be Treated Based on the Results of Invasive Sampling (ie, Bronchoscopy, Blind Bronchial Sampling) With Quantitative Culture Results, Noninvasive Sampling (ie, Endotracheal Aspiration) With Quantitative Culture Results, or Noninvasive Sampling With Semiquantitative Culture Results?

1. We suggest noninvasive sampling with semiquantitative cultures to diagnose VAP, rather than invasive sampling with quantitative cultures and rather than noninvasive sampling with quantitative cultures (weak recommendation, low-quality evidence).

 

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COPD and risk of PE

Chest published an article regarding risk of chronic pulmonary obstructive disease and pulmonary embolism. There are different reported risk from 3% to 30%. In this study, prevalence of pulmonary embolism in unexplained acute exacerbation of COPD reported as high as 16%. We should be worry about PE in patients with unexplained acute exacerbation of COPD who have pleuritic chest pain and signs of cardiac failure without clear infectious origin.

 

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