Pneumonia, ventilator-associated (VAP): Difference between revisions

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*The infection window period (IWP) is defined as the 7-days during which all site-specific infection criteria must be met. It includes the collection date of the first positive chest imaging study (date of onset), that is used as an element to meet the site-specific infection criterion, the 3 calendar days before and the 3 calendar days after.

~~=== Recent previous pneumonia ===~~

*An important CDC guideline is that if a pneumonia of any type is adjudicated to be present, then at least 14 days must pass from its onset before another/different pneumonia can be identified as being present.

**This holds even if the pathogens are different

**This holds even if chest imaging shows infiltrates in different areas of the lungs

**A relevant manifestation of this is if a patient is admitted with a pneumonia (so it's a CAP), and is intubated, the earliest a VAP may occur is on hospital day#14.

*If a patient had any pneumonia previously during the same admission and then develops pneumonia again, meeting the VAP criteria, it is only a VAP if:

** (i) onset was at least 14 days after onset of the previous pneumonia, and

** (ii) it is a new organism and has new and persistent or progressive and persistent infiltrates. If it is the same original organism, then the pneumonia has not completely been resolved, and you should NOT code it as a VAP.

==Data Collection Instructions==

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VAP is an infectious pneumonia in a patient who, as of the day it showed itself (“day of event”) had been on mechanical ventilation (MV), either continuously or intermittently for at least 48 hours before onset of infection.

*The mechanical ventilation must be delivered via an endotracheal tube or tracheostomy.

* While the CDC excludes patients that are on ECMO, we will '''include''' patients that are on ECMO

*Although it is arbitrary, for this purpose we will consider "intermittent ventilation" to mean this: Over the 48 hours prior to the identification of the VAP, that the patient had been on the ventilator, via an ETT or trach, at least twice for periods of at least 1 hour each.

@@ Line 31: / Line 31: @@
 *The infection window period (IWP) is defined as the 7-days during which all site-specific infection criteria must be met. It includes the collection date of the first positive chest imaging study (date of onset), that is used as an element to meet the site-specific infection criterion, the 3 calendar days before and the 3 calendar days after.
+{{Template:ICD10 Recent Previous Pneumonia}}
-=== Recent previous pneumonia ===
-*An important CDC guideline is that if a pneumonia of any type is adjudicated to be present, then at least 14 days must pass from its onset before another/different pneumonia can be identified as being present.
-**This holds even if the pathogens are different
-**This holds even if chest imaging shows infiltrates in different areas of the lungs
-**A relevant manifestation of this is if a patient is admitted with a pneumonia (so it's a CAP), and is intubated, the earliest a VAP may occur is on hospital day#14.
-*If a patient had any pneumonia previously during the same admission and then develops pneumonia again, meeting the VAP criteria, it is only a VAP if:
-** (i) onset was at least 14 days after onset of the previous pneumonia, and
-** (ii) it is a new organism and has new and persistent or progressive and persistent infiltrates. If it is the same original organism, then the pneumonia has not completely been resolved, and you should NOT code it as a VAP.
-{{ICD10 Recent Previous Pneumonia}}
 ==Data Collection Instructions==
@@ Line 56: / Line 44: @@
 VAP is an infectious pneumonia in a patient  who, as of the day it showed itself (“day of event”) had been on mechanical ventilation (MV), either continuously or intermittently for at least 48 hours before onset of infection.
 *The mechanical ventilation must be delivered via an endotracheal tube or tracheostomy.
+* While the CDC excludes patients that are on ECMO, we will '''include''' patients that are on ECMO
 *Although it is arbitrary, for this purpose we will consider "intermittent ventilation" to mean this:  Over the 48 hours prior to the identification of the VAP, that the patient had been on the ventilator, via an ETT or trach, at least twice for periods of at least 1 hour each.