• A Leo, J Galindo-Galindo, E Folch, A Guerrero, F Bosques, R Mercado, and A C Arroliga.
• Hospital Universitario Dr. José Eleuterio González, Monterrey, México.
• Med Intensiva. 2008 Apr 1; 32 (3): 115-20.

ObjectiveOur objective was to compare the results of a blind lavage vs a bronchoscopic-guided bronchoalveolar lavage for the etiologic diagnosis of ventilator-associated pneumonia (VAP).DesignProspective study in consecutive patients with high probability of VAP. Every patient underwent both procedures, in a formally randomized fashion. The interpretation of quantitative cultures was done in a blind fashion.SettingSingle center study, with a 20 bed medical and surgical Intensive Care Unit of the University Hospital in Monterrey, Mexico.PatientsTwenty-five patients with high probability of VAP.InterventionsEvery patient underwent blind bronchoalveolar lavage with a modified nasogastric tube, and a bronchoscopic-guided bronchoalveolar lavage.ResultsTwenty-one patients underwent both procedures. Four patients were excluded due to contamination of the cultures. The quantitative cultures were compared in a paired fashion. Only two patients had discordant cultures. The correlation coefficient between the number of colonies was very high, r=0.90 (95% confidence interval [CI], 0.77-0.96; p=0.0001).ConclusionsThe blind bronchoalveolar lavage with a modified nasogastric tube is a valuable tool for the identification of etiologic agent in VAP, particularly when trained bronchoscopists or the necessary resources for bronchoscopic-guided bronchoalveolar lavage are not readily available.

20 keywords...

hide…