2f9808bd01ecaccd84131261c752b263 311673.pdf c9fd3981589d712805060e65687112fe763005bf 311673.pdf 1504fe6e12418dc1669ec26d67355ca01e99fd830657e70c602eb99f97659b51 311673.pdf Title: The Clinical Pulmonary Infection Score Combined with Procalcitonin and Lung Ultrasound (CPIS-PLUS), a Good Tool for Ventilator Associated Pneumonia Early Diagnosis in Pediatrics Subject: Ventilator-associated pneumonia (VAP) is common in Pediatric Intensive Care Units. Although early detection is crucial, current diagnostic methods are not definitive. This study aimed to identify lung ultrasound (LUS) findings and procalcitonin (PCT) values in pediatric patients with VAP to create a new early diagnosis score combined with the Clinical Pulmonary Infection Score (CPIS), the CPIS-PLUS score. Prospective longitudinal and interventional study. Pediatric patients with suspected VAP were included and classified into VAP or non-VAP groups, based on Centers of Disease Control (CDC) criteria for the final diagnosis. A chest-X-ray (CXR), LUS, and blood test were performed within the first 12 h of admission. CPIS score was calculated. A total of 108 patients with VAP suspicion were included, and VAP was finally diagnosed in 51 (47%) patients. CPIS-PLUS showed high accuracy in VAP diagnosis with a sensitivity (Sn) of 80% (95% CI 65–89%) and specificity (Sp) of 73% (95% CI 54–86%). The area under the curve (AUC) resulted in 0.86 for CPIS-PLUS vs. 0.61 for CPIS. In conclusion, this pilot study showed that CPIS-PLUS could be a potential and reliable tool for VAP early diagnosis in pediatric patients. Internal and external validations are needed to confirm the potential value of this score to facilitate VAP diagnosis in pediatric patients. Keywords: ventilator-associated pneumonia (VAP); lung ultrasound (LUS); procalcitonin (PCT); clinical pulmonary infection score (CPIS) Author: Judit Becerra-Hervás, Carmina Guitart, Aina Covas, Sara Bobillo-Pérez, Javier Rodríguez-Fanjul, Josep L. Carrasco-Jordan, Francisco José Cambra Lasaosa, Iolanda Jordan and Mònica Balaguer Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue May 14 11:27:46 2024 CEST ModDate: Tue May 14 11:33:39 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 904337 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- HBZDJG+URWPalladioL-Bold Type 1 Custom yes yes no 10 0 JFRFDD+URWPalladioL-Roma Type 1 Custom yes yes no 15 0 TZAUIM+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 EUNBMT+VnURWPalladioL Type 1 Custom yes yes no 23 0 MPDLZD+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 YJPPHJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 PHPDYL+CMSY10 Type 1 Builtin yes yes no 64 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 77 0 NUUXUW+VnURWPalladioL-Italic Type 1 Custom yes yes no 112 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-06-26 02:38:40 CEST RepresentationInformation: 311673.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-06-25 14:13:36 CEST Size: 904337 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 383 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Patients Destination: subsection.2.1 Item: Title: Definitions Destination: subsection.2.2 Item: Title: Variables Destination: subsection.2.3 Item: Title: Image Diagnostic Test Destination: subsection.2.4 Item: Title: PCT Values Destination: subsection.2.5 Item: Title: Microbiological Study Destination: subsection.2.6 Item: Title: Data Management Destination: subsection.2.7 Item: Title: Outcomes Destination: subsection.2.8 Item: Title: Statistical Analysis Destination: subsection.2.9 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: The Clinical Pulmonary Infection Score Combined with Procalcitonin and Lung Ultrasound (CPIS-PLUS), a Good Tool for Ventilator Associated Pneumonia Early Diagnosis in Pediatrics Author: Judit Becerra-Hervás, Carmina Guitart, Aina Covas, Sara Bobillo-Pérez, Javier Rodríguez-Fanjul, Josep L. Carrasco-Jordan, Francisco José Cambra Lasaosa, Iolanda Jordan and Mònica Balaguer Subject: Ventilator-associated pneumonia (VAP) is common in Pediatric Intensive Care Units. Although early detection is crucial, current diagnostic methods are not definitive. This study aimed to identify lung ultrasound (LUS) findings and procalcitonin (PCT) values in pediatric patients with VAP to create a new early diagnosis score combined with the Clinical Pulmonary Infection Score (CPIS), the CPIS-PLUS score. Prospective longitudinal and interventional study. Pediatric patients with suspected VAP were included and classified into VAP or non-VAP groups, based on Centers of Disease Control (CDC) criteria for the final diagnosis. A chest-X-ray (CXR), LUS, and blood test were performed within the first 12 h of admission. CPIS score was calculated. A total of 108 patients with VAP suspicion were included, and VAP was finally diagnosed in 51 (47%) patients. CPIS-PLUS showed high accuracy in VAP diagnosis with a sensitivity (Sn) of 80% (95% CI 65 89%) and specificity (Sp) of 73% (95% CI 54 86%). The area under the curve (AUC) resulted in 0.86 for CPIS-PLUS vs. 0.61 for CPIS. In conclusion, this pilot study showed that CPIS-PLUS could be a potential and reliable tool for VAP early diagnosis in pediatric patients. Internal and external validations are needed to confirm the potential value of this score to facilitate VAP diagnosis in pediatric patients. 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