Reyes, Luis Felipe and Serrano-Mayorga, Cristian C. and Zhang, Zhongheng and Tsuji, Isabela and De Pascale, Gennaro and Prieto, Valeria Enciso and Mer, Mervyn and Sheehan, Elyce and Nasa, Prashant and Zangana, Goran and Avanti, Kostoula and Tabah, Alexis and Shrestha, Gentle Sunder and Bracht, Hendrik and Fatoni, Arie Zainul and Abidi, Khalid and bin Sulaiman, Helmi and Eshwara, Vandana Kalwaje and De Bus, Liesbet and Hayashi, Yoshiro and Korkmaz, Pervin and Ait Hssain, Ali and Buetti, Niccolo and Goh, Qing Yuan and Kwizera, Arthur and Koulenti, Despoina and Nielsen, Nathan D. and Povoa, Pedro and Ranzani, Otavio and Rello, Jordi and Conway Morris, Andrew and Reyes, Luis Felipe and Zhang, Zhongheng and Mer, Mervyn and Tabah, Alexis and Kwizera, Arthur and Koulenti, Despoina and Nielsen, Nathan D. and Povoa, Pedro and Ranzani, Otavio and Rello, Jordi and Conway Morris, Andrew and Mphandi, Wilson and Ceccato, Adrian and Tabah, Alexis and Jahan, Ahsina and De Bus, Liesbet and Tsuji, Isabela and Zhang, Zhongheng and Reyes, Luis Felipe and Jibaja, Manuel and Alsisi, Adel and Roquilly, Antoine and Bracht, Hendrik and Arvaniti, Kostoula and Sandoval, Nancy and Eshwara, Vandana Kalwaje and Zainul, Arie and Zand, Faird and De Pascale, Gennaro and Hayashi, Yoshiro and Viderman, Dimitry and Sulaiman, Helmi bin and Lagunes, Leonel and Nasa, Prashant and Zangana, Goran and Abidi, Khalid and Shrestha, Gentle and Schouten, Jeroen and Buowari, Dabota and Hashmi, Madiha and Luque, Nestor and Nora, David and Hssain, Ali Ait and Kuzovlev, Artem and Goh, Qing Yuan and Mer, Mervyn and Rello, Jordi and Hanifa, Rashan and Sjovall, Fredrik and Buetti, Niccollo and Yeh, Tony and Korkmaz, Pervin and Kwizera, Arthur and Shaban, Nesreen and Hamed, Islam and Sheehan, Elyce (2024) D-PRISM: a global survey-based study to assess diagnostic and treatment approaches in pneumonia managed in intensive care. Critical Care, 28 (1). p. 381. ISSN 1364-8535, DOI https://doi.org/10.1186/s13054-024-05180-y.
Full text not available from this repository.Abstract
Background Pneumonia remains a significant global health concern, particularly among those requiring admission to the intensive care unit (ICU). Despite the availability of international guidelines, there remains heterogeneity in clinical management. The D-PRISM study aimed to develop a global overview of how pneumonias (i.e., community-acquired (CAP), hospital-acquired (HAP), and Ventilator-associated pneumonia (VAP)) are diagnosed and treated in the ICU and compare differences in clinical practice worldwide.Methods The D-PRISM study was a multinational, survey-based investigation to assess the diagnosis and treatment of pneumonia in the ICU. A self-administered online questionnaire was distributed to intensive care clinicians from 72 countries between September to November 2022. The questionnaire included sections on professional profiles, current clinical practice in diagnosing and managing CAP, HAP, and VAP, and the availability of microbiology diagnostic tests. Multivariable analysis using multiple regression analysis was used to assess the relationship between reported antibiotic duration and organisational variables collected in the study.Results A total of 1296 valid responses were collected from ICU clinicians, spread between low-and-middle income (LMIC) and high-income countries (HIC), with LMIC respondents comprising 51% of respondents. There is heterogeneity across the diagnostic processes, including clinical assessment, where 30% (389) did not consider radiological evidence essential to diagnose pneumonia, variable collection of microbiological samples, and use and practice in bronchoscopy. Microbiological diagnostics were least frequently available in low and lower-middle-income nation settings. Modal intended antibiotic treatment duration was 5-7 days for all types of pneumonia. Shorter durations of antibiotic treatment were associated with antimicrobial stewardship (AMS) programs, high national income status, and formal intensive care training.Conclusions This study highlighted variations in clinical practice and diagnostic capabilities for pneumonia, particularly issues with access to diagnostic tools in LMICs were identified. There is a clear need for improved adherence to existing guidelines and standardized approaches to diagnosing and treating pneumonia in the ICU. Trial registration As a survey of current practice, this study was not registered. It was reviewed and endorsed by the European Society of Intensive Care Medicine.Conclusions This study highlighted variations in clinical practice and diagnostic capabilities for pneumonia, particularly issues with access to diagnostic tools in LMICs were identified. There is a clear need for improved adherence to existing guidelines and standardized approaches to diagnosing and treating pneumonia in the ICU. Trial registration As a survey of current practice, this study was not registered. It was reviewed and endorsed by the European Society of Intensive Care Medicine.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Pneumonia; Community-acquired; Hospital-acquired; Ventilator-associated; Intensive care unit (ICU); Antimicrobials; Bronchoscopy; Surveys and questionnaires |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 12 Mar 2025 08:40 |
| Last Modified: | 12 Mar 2025 08:40 |
| URI: | http://eprints.um.edu.my/id/eprint/47287 |
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