SynthesisCritical care (London, England)2024
Unravelling the complexity of ventilator-associated pneumonia: a systematic methodological literature review of diagnostic criteria and definitions used in clinical research.
Synthesis in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Incidence rate and risk factors of ventilator-associated pneumonia in neurocritical patients with acute cerebrovascular diseases: A systematic review and meta-analysis of observational studies.The Journal of international medical research · 2026Pooled it
- Risk factors and outcomes of ventilator-associated pneumonia: an updated systematic review and meta-analysis.BMC pulmonary medicine · 2025Pooled it
- Application of double-sleeve endotracheal tube in infection control for icu patients: a randomized controlled trial.Head & face medicine · 2025Trial
- Phantom system for endotracheal tube cuff seal testing during mechanical ventilation.Medical & biological engineering & computing · 2026Article
- Response to Matters Arising about the etiology of ventilator-associated pneumonia in the European POS-VAP cohort.Critical care (London, England) · 2026Article
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Daily Chlorhexidine Bathing for the Prevention of Nosocomial Infections in Critically Ill Patients (CLEAN-IT): a multicentre, cluster-randomised, crossover trial.Lancet regional health. Americas · 2026Article
- Biomarker-based diagnosis of ventilator-associated pneumonia using serum and bronchoalveolar lavage fluid levels of presepsin, procalcitonin, and lipopolysaccharide-binding protein.Frontiers in cellular and infection microbiology · 2026Article
- Clinical impact of healthcare-associated infections in Brazilian ICUs: a multicenter prospective cohort.Critical care (London, England) · 2025Article
- Prevalence of ventilator-associated pneumonia and bacterial isolates in mechanically ventilated dogs.Frontiers in veterinary science · 2025Article
- D-PRISM: a global survey-based study to assess diagnostic and treatment approaches in pneumonia managed in intensive care.Critical care (London, England) · 2024Article
- Duration of Antimicrobial Treatment in Adult Patients with Pneumonia: A Narrative Review.Antibiotics (Basel, Switzerland) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundVentilator-associated pneumonia (VAP) is a prevalent and grave hospital-acquired infection that affects mechanically ventilated patients. Diverse diagnostic criteria can significantly affect VAP research by complicating the identification and management of the condition, which may also impact clinical management.
objectivesWe conducted this review to assess the diagnostic criteria and the definitions of the term "ventilator-associated" used in randomised controlled trials (RCTs) of VAP management. SEARCH
methodsBased on the protocol (PROSPERO 2019 CRD42019147411), we conducted a systematic search on MEDLINE/PubMed and Cochrane CENTRAL for RCTs, published or registered between 2010 and 2024. SELECTION CRITERIA: We included completed and ongoing RCTs that assessed pharmacological or non-pharmacological interventions in adults with VAP. DATA COLLECTION AND SYNTHESIS: Data were collected using a tested extraction sheet, as endorsed by the Cochrane Collaboration. After cross-checking, data were summarised in a narrative and tabular form.
resultsIn total, 7,173 records were identified through the literature search. Following the exclusion of records that did not meet the eligibility criteria, 119 studies were included. Diagnostic criteria were provided in 51.2% of studies, and the term "ventilator-associated" was defined in 52.1% of studies. The most frequently included diagnostic criteria were pulmonary infiltrates (96.7%), fever (86.9%), hypothermia (49.1%), sputum (70.5%), and hypoxia (32.8%). The different criteria were used in 38 combinations across studies. The term "ventilator-associated" was defined in nine different ways.
conclusionsWhen provided, diagnostic criteria and definitions of VAP in RCTs display notable variability. Continuous efforts to harmonise VAP diagnostic criteria in future clinical trials are crucial to improve quality of care, enable accurate epidemiological assessments, and guide effective antimicrobial stewardship.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.