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

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​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 free days.