Clinical Pulmonary Infection Score (CPIS) for Ventilator-Associated Pneumonia (VAP)

CPIS for VAP

Temperature (°C)

WBC (×10³/µL)

Tracheal Secretions

Oxygenation (PaO₂/FiO₂)

Chest X-Ray

Culture of Tracheal Aspirate

Score:–

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Assists in diagnosing ventilator-associated pneumonia by predicting benefit of pulmonary cultures.

Why Use

VAP is a tricky diagnosis with many confounders. Using a scoring system may be better than using common clinical gestalt.

When to Use

Patients being evaluated for possible ventilator-associated pneumonia.

Formula

Addition of selected points.

Pearls / Pitfalls

The CPIS, at a cut-off of >6 points to diagnose ventilator-associated pneumonia (VAP), seems poorly sensitive and specific. The few derivation, validation, and autopsy studies, mostly with small selected cohorts, suggest the score may be inaccurate. However, a reasonable reference standard for defining VAP remains elusive, making this a tricky analysis.

Management

We are unaware of validated management algorithms using the CPIS.

Critical Actions

CPIS requires aspirate analysis, gram stain and other important laboratory variables.

Advice

The CPIS score is based on sensible elements, and the likelihood of VAP does seem to be somewhat higher when scores are >6; however, the utility and role of the score remain unknown.

More Information

Scores ≥ 7 may indicate higher likelihood of VAP and need for BAL or mini- BAL .