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* All values of PEEP less than 5 cmH2O are considered to be 5 cmH2O for purposes of the VAC definition. So for PEEP values entered as less than or equal to 5 cmH2O, an increase in the daily minimum PEEP to at least 8 cmH2, sustained for 2 or more calendar days, is required to meet the VAC definition.

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Question Yes
Criterion 1. Positive culture of one of the following (without requirement for purulent respiratory secretions):
  • Endotracheal aspirate ≥ 105 cfu/ml*
  • Bronchoalveolar lavage ≥ 104 cfu/ml*
  • Lung tissue ≥ 104 cfu/ml*
  • Protected specimen brush ≥ 103 cfu/ml*
*or corresponding semi-quantitative result

Criterion 2. Positive culture of one of the following (qualitative or quantitative/semi-quantitative culture without sufficient growth to meet Criterion 1).
  • Sputum
  • Endotracheal aspirate
  • Bronchoalveolar lavage
  • Lung tissue
  • Protected specimen brush

Evidence of purulent respiratory secretions (defined as secretions from lungs, bronchi or trachea that contain ≥ 25 neutrophils and ≤ 10 squamous epithelial cells).

Criterion 3. One of the following positive tests (as outlined in the protocol):
  • Pleural fluid culture
  • Lung histopathology
  • Diagnostic test for Legionella species
  • Diagnostic test for influenza virus, respiratory syncytial virus, adenovirus, parainfluenza virus, rhinovirus, human metapneumovirus or coronavirus.