Ventilator Associated Pneumonia
This study started in 2011 and is lead by Professor John Simpson with funding from the Health Innovation Challenge Fund Welcome Trust
About the project
VAP is an iatrogenic condition that typically occurs in 12-40% of critically ill
patients who are intubated and mechanically ventilated for more than 2
days.3-8 Overall mortality associated with VAP generally ranges from
20-40%. However it is often difficult to prove the presence of bacteria.
Earlier bedside diagnosis of a bacterial cause for the VAP in a given
patient, using this technique could lead to a reduction in mortality but
equally lack of proof of actual bacterial infection could shorten the
course of potentially unnecessary antibiotics. Ultimately this would
slow the onset of multi-resistant bacteria evolving in response to
indiscriminate use of antibiotics.
Phase 1 is a study of 100 patients with VAP criteria
clinically proven from 5 ICUs who will have Bronchoscopic Lavage fluid
will be sent for microbiology and centrifuged for additional analysis of
cytokines IL-1b, HNE, MMP-8, MMP-9, IL-8. The results will be used to
test whether IL-1b levels can be used to exclude VAP.
Phase 2 of the study patients will be randomised to 2 groups.
In the control group the Cytokine test will not be performed and
antibiotic management will be according to normal practice. In the
treatment arm, Cytokine results will be used to either stop or continue
with antibiotic therapy. The outcome will be a reduction in antibiotic