Background & Objectives: Ventilator associated pneumonia (VAP) is an important form of hospital acquired pneumonia (HAP), specifically developing in a mechanically ventilated patient more than 48 hours after tracheal intubation. The overall or crude mortality associated with VAP ranges from 40% to 70% varying with underlying illness. Recent studies have shown that Clinical pulmonary infection score and CRP are valuable tool in detection of early VAP. The aim of the study  was  correlate clinical pulmonary infection score and c-reactive protein in the prediction of early ventilator associated pneumonia

Methods: In this study we have taken 30 patients who were above 18 yrs diagnosed to have Early Ventilator associated pneumonia and subjects on immunosuppressive therapy, chemotherapy and AIDS, Patient intubated outside hospital and refered were excluded.  Serial CRP levels were measured later CPIS was calculated With the onset of chest infilterate, ET Tube Aspirate culture was obtained for confirmation of VAP.

Results: 30 patients were enrolled. CPIS Score was calculated in 22 patients who developed early VAP which is confirmed by ET tube aspirate culture and sensitivity. CPIS Score of > 6 in cases who developed early VAP which is confirmed by ET Culture and sensitivity was statistically significant  on  Day 4 with p value of  0.016 , But it was not significant on Day 3 and 5 .Over all statistical analysis of CPIS Value of >6 in 18 patients who developed early VAP was significant (P value 0.003). There was serial rise in the titers of CRP levels but CRP levels did not show any stastical significance with CPIS score in VAP patients.

Conclusion: Study showed when the CPIS exceeded 6, there was an association with the presence of pneumonia in mechanically ventilated patients which was confirmed by ET tube aspiration culture. serum CRP is an easy, available and cheap test so serial rise in titres of CRP in mechanically ventilated  patients  along with CPIS helps in the early diagnosis of pneumonia and aggressive treatment to prevent mortality and morbidity.

Keywords: Ventilator associated pneumonia; C reactive protein; Clinical pulmonary infection score; Hospital acquired pneumonia.

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Dr Basanth Kumar S

Associate Professor, Dept of General Medicine

KIMS Hospital Bengaluru, India