Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs more than 48 hours after intubation. Its diagnosis is based on clinical signs and symptoms such as a new infiltrate on the chest X- ray. Since culture-based identification of the causative pathogen is slow, the nature of the causative pathogen often only confirms an initial diagnosis and might guide antibiotic treatment. A rapid diagnostic test may potentially improve the clinical pathways associated with VAP.
In this work package, hospital-acquired lower respiratory tract infections served as an example of how the demand side from a clinical perspective can be matched with the currently available innovative diagnostic. Therefore, we matched the clinical decision tree of VAP with the currently available diagnostic tests. We first analyzed the online available VAP guidelines and compared their parameters to diagnose and the treatment considerations for VAP. Also, the clinical scoring systems available for VAP was discussed. Secondly, we defined and discussed a clinical decision tree for VAP based on these guidelines. Thirdly, we evaluated the opportunity of rapid diagnostic tests for a potential inclusion for the clinical decision tree. Lastly, we contacted a VAP expert panel to include their suggested clinical decision tree received. This resulted in a clear picture on the proposed clinical pathway for the diagnosis of VAP, the technical specification for the diagnostic test and the first draft of the URS.
