Non-bronchoscopic bronchoalveolar lavage in the microbiological diagnosis of pneumonia in mechanically ventilated patients

被引:14
作者
Arora, SC [1 ]
Mudaliar, YM [1 ]
Lee, C [1 ]
Mitchell, D [1 ]
Iredell, J [1 ]
Lazarus, R [1 ]
机构
[1] Westmead Hosp, Dept Intens Care, Westmead, NSW 2145, Australia
关键词
infection; pneumonia; ventilator-associated; hospital-acquired; community-acquired; tracheal aspirate; bronchoalveolar lavage;
D O I
10.1177/0310057X0203000102
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
A prospective study comparing standardized non-bronchoscopic bronchoalveolar lavage (sNB-BAL) and nonspecific endotracheal aspirate (NsETA) in the microbiological diagnosis of pneumonia in mechanically ventilated patients is described. One hundred episodes in 82 mechanically ventilated patients with or without radiological and clinical diagnostic criteria of pneumonia were studied. NsETA and sNB-BAL was performed on the day of study. Fifty-one patients had pneumonia (21 ventilator-associated, 12 hospital-acquired, 18 community-acquired) and 49 had no pneumonia as defined by widely accepted clinico-radiological criteria. The sNB-BAL was found to be significantly more specific (0.73) compared to NsETA (0.35) for the microbiological diagnosis of pneumonia. Colonization rates with NsETA were significantly higher compared to sNB-BAL (P value <0.0001). No patient had complications attributable to the sNB-BAL procedure. We conlude that sNB-BAL is a safe, effective, sensitive, specific and inexpensive procedure for the serial evaluation of pneumonia in mechanically ventilated patients.
引用
收藏
页码:11 / 20
页数:10
相关论文
共 61 条
[1]   NONBRONCHOSCOPIC APPROACH TO BRONCHOALVEOLAR LAVAGE IN CHILDREN WITH ARTIFICIAL AIRWAYS [J].
ALPERT, BE ;
OSULLIVAN, BP ;
PANITCH, HB .
PEDIATRIC PULMONOLOGY, 1992, 13 (01) :38-41
[2]   DIAGNOSIS OF NOSOCOMIAL BACTERIAL PNEUMONIA IN ACUTE, DIFFUSE LUNG INJURY [J].
ANDREWS, CP ;
COALSON, JJ ;
SMITH, JD ;
JOHANSON, WG .
CHEST, 1981, 80 (03) :254-258
[3]  
Baselski Vickie S., 1994, Clinical Microbiology Newsletter, V16, P65, DOI 10.1016/0196-4399(94)90062-0
[4]   THE STANDARDIZATION OF CRITERIA FOR PROCESSING AND INTERPRETING LABORATORY SPECIMENS IN PATIENTS WITH SUSPECTED VENTILATOR-ASSOCIATED PNEUMONIA [J].
BASELSKI, VS ;
ELTORKY, M ;
COALSON, JJ ;
GRIFFIN, JP .
CHEST, 1992, 102 (05) :S571-S579
[5]   ''Blind'' protected specimen brushing versus bronchoscopic techniques in the aetiolological diagnosis of ventilator-associated pneumonia [J].
Bello, S ;
Tejada, A ;
Chacon, E ;
Villuendas, MC ;
Senar, A ;
Gascon, M ;
Suarez, FJ .
EUROPEAN RESPIRATORY JOURNAL, 1996, 9 (07) :1494-1499
[7]   BACTEREMIC NOSOCOMIAL PNEUMONIA - ANALYSIS OF 172 EPISODES FROM A SINGLE METROPOLITAN AREA [J].
BRYAN, CS ;
REYNOLDS, KL .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1984, 129 (05) :668-671
[8]  
CARTIER F, 1987, INTENS CARE MED, V13, P87
[9]   NONBRONCHOSCOPIC BRONCHOALVEOLAR LAVAGE FOR THE DIAGNOSIS FOR PNEUMOCYSTIS-CARINII PNEUMONIA IN THE ACQUIRED IMMUNODEFICIENCY SYNDROME [J].
CAUGHEY, G ;
WONG, H ;
GAMSU, G ;
GOLDEN, J .
CHEST, 1985, 88 (05) :659-662
[10]   NOSOCOMIAL PNEUMONIA - A MULTIVARIATE-ANALYSIS OF RISK AND PROGNOSIS [J].
CELIS, R ;
TORRES, A ;
GATELL, JM ;
ALMELA, M ;
RODRIGUEZROISIN, R ;
AGUSTIVIDAL, A .
CHEST, 1988, 93 (02) :318-324