Early Predictors of Ventilator Associated Pneumonia in Preterm Neonates Admitted in a Special Newborn Care Unit

Pahwa, Simran; Sethi, Amanpreet; Kaur, Gurmeet; Dhir, Shashi Kant; Jindal, Neerja; Rai, Seema; Jindal, Sakshi

doi:10.1007/s13312-024-3086-3

Indian Pediatr

2024

DOI: 10.1007/s13312-024-3086-3

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Early Predictors of Ventilator Associated Pneumonia in Preterm Neonates Admitted in a Special Newborn Care Unit

Simran Pahwa,

Amanpreet Sethi,

Gurmeet Kaur

et al.

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Endotracheal Tube Aspirate Microscopy and Culture vs CDC Criteria for Early Diagnosis of VAP in Special Newborn Care Units

Neopane,

Bora,

Sethi

2024

Indian Pediatr

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We read with interest the article by Pahwa et al [1]. A few important points need elaboration for a better understanding. The study excluded neonates with suspected/ diagnosed pneumonia at the time of initiation of mechanical ventilation (MV), major congenital malformations, pulmonary hemorrhage, outborn neonates intubated at admission or with a history of MV. With the gestational age (GA) of study population being < 32 weeks, and with exclusion of most conditions for which neonates are intubated at this GA, it is difficult to assume the causes of ventilation of included neonates. As less invasive surfactant administration (LISA) and continuous positive airway pressure (CPAP) is commonly practiced in most units, we are unsure if the included neonates with respiratory distress syndrome (RDS) met the inclusion criteria. A flow diagram mentioning total number of deliveries, number of neonates with antenatal steroids, and the number of excluded neonates with reasons would have been useful.Authors mentioned that endotracheal aspirate (ETA) samples were collected after 48 hours of MV using an open method. However, critical details regarding procedure remains unclear. Authors need to clarify if they took any growth on culture as indication of VAP and how was any colonization excluded. We would like to know the correlation between blood culture and ETA culture. Although authors mentioned that ETA culture and microscopy were superior to CDC criteria (in terms of time) for diagnosing VAP, the percentage difference between two methods and their correlation if any was not specified.

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Endotracheal Tube Aspirate Microscopy and Culture vs CDC Criteria for Early Diagnosis of VAP in Special Newborn Care Units

Neopane,

Bora,

Sethi

2024

Indian Pediatr

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