Comparison of Nonbronchoscopic Techniques with Bronchoscopic Brushing in the Diagnosis of Ventilator-Associated Pneumonia

Wearden, Peter D.; Chendrasekhar, Akella; Timberlake, Gregory A.

doi:10.1097/00005373-199610000-00018

Cited by 28 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Diagnostic accuracy is improved by the use of PSB, a technique introduced by WIMBERLEY et al [77], and BAL, at first using a bronchoscope but later not bronchoscopically taken (NB-BAL). The latter procedure is much more rapid and provides similar microbiological data in the diagnosis of ventilator-associated pneumonia [78,79].…”

Section: Psb and Balmentioning

confidence: 99%

Guidelines for the management of adult lower respiratory tract infections

Woodhead¹

2005

European Respiratory Journal

678

555

View full text Add to dashboard Cite

Section: Psb and Balmentioning

confidence: 99%

Guidelines for the management of adult lower respiratory tract infections

Woodhead¹

2005

European Respiratory Journal

678

555

View full text Add to dashboard Cite

“…Diagnostic accuracy is improved by the use of a protected specimen brush (PSB) (110) and BAL, at first performed through a bronchoscope and later not bronchoscopically taken (NB-BAL) (6,107). These procedures carry less risk and are usually more acceptable to patients than transtracheal aspiration and direct needle aspiration of the lung.…”

Section: Optimal Samples For Detection Of Respiratory Pathogens Invasmentioning

confidence: 99%

Optimal Sampling Sites and Methods for Detection of Pathogens Possibly Causing Community-Acquired Lower Respiratory Tract Infections

et al. 2009

View full text Add to dashboard Cite

“…Up to 100 ml of saline is instilled and suctioned until at least 25 ml of specimen is obtained. This blind technique is quicker and cheaper to perform and has good concordance with bronchoscopic techniques [19]. The good agreement between bronchoscopic and nonbronchoscopic techniques emphasises the disseminated nature of lower respiratory tract colonisation and infection in intubated critically ill patients.…”

Section: Nonbronchoscopic Psb and Balmentioning

confidence: 68%

Ventilator‐associated pneumoniaDiagnosis, pathogenesis and prevention

Young¹,

Ridley²

1999

Anaesthesia

View full text Add to dashboard Cite

SummaryVentilator-associated pneumonia is common, difficult to diagnose, affects the most vulnerable of patients and carries a high mortality. During prolonged mechanical ventilation the oropharynx, sinuses, dentition and stomach of critically ill patients become colonised with pathogenic bacteria. Colonised secretions pool in the oropharynx and subglottic space. These secretions repeatedly gain access to the lower airways by leakage past the tracheal tube cuff. If host defence mechanisms are overwhelmed, multiplication occurs in the lower respiratory tract producing an inflammatory response in the bronchioles and alveoli. The inflammatory response is characterised by capillary congestion, leucocyte and macrophage infiltration and fibrinous exudation into the alveolar spaces. If this inflammatory response occurs more than 48 h after intubation, it is called ventilatorassociated pneumonia. Prevention depends on reducing upper airway and gastrointestinal reservoirs of bacteria, reducing or abolishing aspiration of these bacteria past the tracheal tube cuff and enhancing bacterial clearance from the lower airways. Despite an increased understanding of the pathogenesis and diagnosis of ventilator-associated pneumonia (VAP), prevention has remained problematic. There is now good evidence for continuous leakage of infected secretions past the tracheal tube cuff being responsible for VAP. As a result, VAP strikes critically ill patients and increases their morbidity and mortality. The aim of this review is to discuss the diagnosis and pathogenesis of VAP, including a brief review of natural defence mechanisms. The review also covers the prevention of VAP with special reference to new developments aimed at reducing aspiration past the cuff. Definition

show abstract

Comparison of Nonbronchoscopic Techniques with Bronchoscopic Brushing in the Diagnosis of Ventilator-Associated Pneumonia

Abstract: Nonbronchoscopic PSB and BAL provide similar microbiologic data to bronchoscopic PSB in the diagnosis of ventilator-associated pneumonia while shortening procedure time significantly.

Cited by 28 publications

References 26 publications

Guidelines for the management of adult lower respiratory tract infections

Guidelines for the management of adult lower respiratory tract infections

Optimal Sampling Sites and Methods for Detection of Pathogens Possibly Causing Community-Acquired Lower Respiratory Tract Infections

Ventilator‐associated pneumoniaDiagnosis, pathogenesis and prevention

Contact Info

Product

Resources

About