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

来源：

ANAESTHESIA AND INTENSIVE CARE | 2002年 / 30卷 / 01期

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

页码：11 / 20

页数：10

共 61 条

[21] DETECTION OF NOSOCOMIAL LUNG INFECTION IN VENTILATED PATIENTS - USE OF A PROTECTED SPECIMEN BRUSH AND QUANTITATIVE CULTURE TECHNIQUES IN 147 PATIENTS [J].

FAGON, JY ;

CHASTRE, J ;

HANCE, AJ ;

GUIGUET, M ;

TROUILLET, JL ;

DOMART, Y ;

PIERRE, J ;

GIBERT, C .

AMERICAN REVIEW OF RESPIRATORY DISEASE, 1988, 138 (01) :110-116

[22] NOSOCOMIAL PNEUMONIA IN PATIENTS RECEIVING CONTINUOUS MECHANICAL VENTILATION - PROSPECTIVE ANALYSIS OF 52 EPISODES WITH USE OF A PROTECTED SPECIMEN BRUSH AND QUANTITATIVE CULTURE TECHNIQUES [J].

FAGON, JY ;

CHASTRE, J ;

DOMART, Y ;

TROUILLET, JL ;

PIERRE, J ;

DARNE, C ;

GIBERT, C .

AMERICAN REVIEW OF RESPIRATORY DISEASE, 1989, 139 (04) :877-884

[23] Diagnosis of ventilator-associated pneumonia [J].

Flanagan, PG .

JOURNAL OF HOSPITAL INFECTION, 1999, 41 (02) :87-99

[24] COMPARISON OF NONBRONCHOSCOPIC BRONCHOALVEOLAR LAVAGE TO OPEN LUNG-BIOPSY FOR THE BACTERIOLOGIC DIAGNOSIS OF PULMONARY INFECTIONS IN MECHANICALLY VENTILATED PATIENTS [J].

GAUSSORGUES, P ;

PIPERNO, D ;

BACHMANN, P ;

BOYER, F ;

JEAN, G ;

GERARD, M ;

LEGER, P ;

ROBERT, D .

INTENSIVE CARE MEDICINE, 1989, 15 (02) :94-98

[25]

GAUSSORGUES P, 1989, INTENS CARE MED, V13, P259

[26]

GRAVEVE AM, 1980, AM J SURG, V140, P742

[27] SELECTION AND INTERPRETATION OF DIAGNOSTIC-TESTS AND PROCEDURES - PRINCIPLES AND APPLICATIONS [J].

GRINER, PF ;

MAYEWSKI, RJ ;

MUSHLIN, AI ;

GREENLAND, P .

ANNALS OF INTERNAL MEDICINE, 1981, 94 (04) :553-+

[28] NOSOCOMIAL INFECTIONS AND HOSPITAL DEATHS - A CASE-CONTROL STUDY [J].

GROSS, PA ;

VANANTWERPEN, C .

AMERICAN JOURNAL OF MEDICINE, 1983, 75 (04) :658-662

[29]

HAPHAM L, 1991, AM REV RESPIR DIS, V143, P1055

[30] NOSOCOMIAL RESPIRATORY-INFECTIONS WITH GRAM-NEGATIVE BACILLI - SIGNIFICANCE OF COLONIZATION OF RESPIRATORY TRACT [J].

JOHANSON, WG ;

SANFORD, JP ;

THOMAS, GD ;

PIERCE, AK .

ANNALS OF INTERNAL MEDICINE, 1972, 77 (05) :701-+

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