• Anil Sachdev, Krishan Chugh, Veena Raghunathan, Chand Wattal, and Geetha R Menon.
• Department of Pediatrics, Sir Ganga Ram Hospital, New Delhi, Delhi, India.
• Pediatr Crit Care Me. 2013 Jan 1;14(1):e1-7.

ObjectiveTo evaluate the reproducibility of blind bronchial sampling in patients with suspected diagnosis of bacterial ventilator-associated pneumonia.DesignProspective study.SettingPediatric intensive care unit of a tertiary care, multidisciplinary, teaching hospital in Northern India.PatientsAll consecutive patients on mechanical ventilation for >48 hrs were evaluated clinically for ventilator-associated pneumonia.InterventionsChildren with clinical ventilator-associated pneumonia were subjected to blind bronchial sampling twice.Measurements And Main ResultsSixty-eight blind bronchial sampling samples from 34 patients were analyzed for polymorphonuclear cells, the presence, type, and number of bacteria. Acinetobacter baumannii was the most common organism grown from distal respiratory secretions. For polymorphonuclear cells, the concordance between two blind bronchial samples was 85.3% and kappa coefficient was 0.65. The concordance for the presence and type of bacteria in Gram staining in two samples was 85.3% and kappa coefficient was 0.68. The intraclass coefficients for bacterial index and predominant species index were 0.82 (95% confidence interval 0.65-0.91) and 0.89 (95% confidence interval 0.78-0.94), respectively. The use of prior antibiotics did not adversely affect the reproducibility of blind bronchial sampling. No major complications were recorded during the procedure.ConclusionsBlind bronchial sampling of lower respiratory tract secretions in mechanically ventilated patients generates reproducible results of quantitative and qualitative cultures. We suggest that blind bronchial sampling may provide valuable clue to the bacterial etiology in ventilated child with suspected clinical ventilator-associated pneumonia.

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