TY  - JOUR
T1  - Assessment of Efficiency of Using Clinical Pulmonary Infection
Score (CPIS) Among Mechanically Ventilated Cases
AU - Ayman Mahmoud Heikal, Sara Ahmed AU - Hamed Mohammed, Lamia`a AU - Ahmed Essawi Saleh, Doa`a AU - Abd Elazeem, Salwa AU - Yassin, Sahar 
JO  - Research Journal of Medical Sciences
VL  - 13
IS  - 2
SP  - 20
EP  - 24
PY  - 2019
DA  - 2001/08/19
SN  - 1815-9346
DO  - rjmsci.2019.20.24
UR  - https://makhillpublications.co/view-article.php?doi=rjmsci.2019.20.24
KW  - Acute Physiology and Chronic Health EvaluationAPACHE and cost
KW  -Mechanical Ventilation MV
KW  -Intensive Care Unit ICU
KW  -Ventilator Associated Pneumonia VAP
KW  -Clinical Pulmonary Infection Score CPIS
KW  -management
AB  - Ventilator-Associated Pneumonia (VAP) is a common Healthcare Associated Infection (HAI) in
critical care department;VAP occurs frequently and is associated with significant morbidity and mortality in
critically ill patients. This study aimed to improve health outcome of patients on Mechanical Ventilation (MV)
through early diagnosis of (VAP), early management with appropriate antibiotics prescription using Clinical
Pulmonary Infection Score (CPIS). Operational research, quasi-experimental interventional study design. The
study was conducted in the in critical care department in the Faculty of Medicine Cairo-University. The study
has 2 phases; Phase 1: recruiting the control group (40 cases) on MV not using CPIS. Phase 2: recruiting the
interventional group (40 cases) on MV using CPIS. The CPIS at day 1 was calculated based on first five
variables which are temperature, blood leukocyte count, tracheal secretions, oxygenation and character of
pulmonary infiltrate in the X-ray. At day 3 of MV the CPIS was calculated based on all seven variables and took
into consideration the progression of the infiltrate in chest X-ray and culture results of the tracheal aspirate,
a score >6 at baseline or at 72 h is considered suggestive of pneumonia. If < = 6 at 72 h patient probably doesn&#146;t
have pneumonia and antibiotics probably can be stopped. Most of the cases were admitted in both groups due
to Cardiovascular diseases CVS and neurological diseases CNS and the most common cause of ventilation was
Disturbed Conscious Level DCL followed by post arrest cases. The most common organism in control group
was <i>Klebsiella</i> 25% and in intervention group was MRSA 17.5%. The CPIS was lower in intervention group
at the day 3 with significant difference p = 0.01. Deathsin intervention group (who were followed by CPIS) were
insignificantly lower. The median of total cost and medication cost were lower in intervention group and
themedian of antibiotic cost was significantly lower in patients (who were followed by CPIS) in intervention
group than control group p = 0.01. CPIS considered tool to monitor patient&#146;s condition on MV and monitor their
response to antibiotic treatment for early modification which in turn reflected on hospital stay and cost.
ER  -