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Friday, 06/04/2010
The city of the Katrina hosted the latest insights on pulmonary and critical care medicine
The importance of preventive bundles was highly emphasized during the conference, written by Gianluigi Li Bassi
The annual International Conference of the American Thoracic Society was held in New Orleans on late May and there were presented the latest insights on ventilator-associated pneumonia (VAP). New treatments with probiotics and the evaluation of inflammatory markers in order to improve diagnosis are some of the highlights.
The meeting was opened with the touching keynote address by Dr. Bennett deBoisblanc, Director of Critical Care Services at the Medical Center of Louisiana. In 2005, Dr. deBoisblanc led a team of healthcare professionals who cared for ICU patients at New Orleans Charity Hospital in the days after Hurricane Katrina. His address recounted several astonishing experiences during those days and the lessons learned about medicine and life.
Among the many topics in adult and pediatric respiratory medicine, latest insights on ventilator-associated pneumonia (VAP) were presented. VAP still complicates the intensive care unit stay of a significant proportion of mechanically ventilated patients. The importance of preventive bundles was highly emphasized. In particular, new treatments with probiotics, such as Lactobacillus, are showing interesting results on reduction of gastrointestinal colonization with pathogens and decreased risks for VAP.
As for diagnosis and treatment, VAP still lacks of a diagnostic gold standard. Several inflammatory markers are being extensively evaluated in order to improve accuracy of the diagnosis and reduce usage of antibiotics. New monoclonal antibodies such as KBPA-101 directed against O polysaccharide moiety of Pseudomonas Aeruginosa O11 and monoclonal antibody against Pseudomonas Aeruginosa Type III secretion proteins PcrV are being evaluated as new adjunctive treatments for Pseudomonas Aeruginosa VAP.
Ultimately, new interesting studies are highlighting limitations of standard microbiologic assays to quantify causative organisms in VAP. New tests through real-time polymerase chain reaction are showing stimulating and promising perspectives in the diagnosis of ventilator-associated pneumonia