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    Patent Pending

    Clinical Pulmonary Infection Score (CPIS) for Ventilator-Associated Pneumonia (VAP)

    Assists in diagnosing ventilator-associated pneumonia by predicting benefit of pulmonary cultures.
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    INSTRUCTIONS

    Many reviews of the CPIS feel it should not be relied on; we include it because of its popularity but caution users to review the data on its utility first.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients being evaluated for possible ventilator-associated pneumonia.

    The CPIS, at a cut-off of >6 points to diagnose ventilator-associated pneumonia (VAP), seems poorly sensitive and specific. The few derivation, validation, and autopsy studies, mostly with small selected cohorts, suggest the score may be inaccurate. However, a reasonable reference standard for defining VAP remains elusive, making this a tricky analysis.

    VAP is a tricky diagnosis with many confounders. Using a scoring system may be better than using common clinical gestalt.

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The CPIS score is based on sensible elements, and the likelihood of VAP does seem to be somewhat higher when scores are >6; however, the utility and role of the score remain unknown.

    Management

    We are unaware of validated management algorithms using the CPIS.

    Critical Actions

    CPIS requires aspirate analysis, gram stain and other important laboratory variables.

    Dr. Carolina A.M. Schurink

    About the Creator

    Carolina A.M. Schurink, MD, is a professor of medicine and practicing physician at the Erasmus University Medical Center in Rotterdam, Netherlands.

    To view Dr. Carolina A.M. Schurink's publications, visit PubMed