Diagnostic accuracy of protected catheter sampling in ventilator-associated bacterial pneumonia
Diagnostic accuracy of protected catheter sampling in ventilator-associated bacterial pneumonia
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DOI：
10.1183/09031936.00.16596900
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发表时间：
2000-11-01
影响因子：
24.3
通讯作者：
Auffray, JP
中科院分区：
文献类型：
--
作者：
Bregeon, F;Papazian, L;Auffray, JP
本研究的目的是评估使用以下方法进行保护性伸缩导管的准确性：1）保护性远端抽吸，或 2）保护性小支气管肺泡灌洗用于诊断呼吸机相关细菌性肺炎。一项比较性前瞻性尸检研究纳入了 27 名接受机械通气至少 72 小时后死亡的患者。两种微生物采样程序均在死亡后立即进行，死亡后30分钟内在床边进行外科肺切除术和活检以进行组织学检查，将两种技术的结果与死后肺检查或活检的组织学进行比较。14例实质组织学检查显示肺炎征象。这14例中有9例肺组织培养呈阳性。当通过组织学体征和阳性肺组织培养的关联来定义呼吸机相关细菌性肺炎时，两种采样技术的敏感性均为 78%，小型支气管肺泡灌洗的特异性为 86%，受保护的远端抽吸的特异性为 100%（阈值为 1 x 10(3) cfu.mL(-1)）。两种技术都保护远端抽吸和小型支气管肺泡灌洗，并提供良好的特异性对呼吸机相关细菌性肺炎的诊断具有可接受的敏感性。
The aim of this study was to assess the accuracy of protected telescoping catheter performed using: 1) protected distal aspiration, or 2) protected mini-bronchoalveolar lavage for the diagnosis of ventilator-associated bacterial pneumonia.Twenty-seven patients who died after receiving mechanical ventilation for at least 72 h were included in a comparative prospective post-mortem study. The two microbiological sampling procedures were performed immediately after death, Surgical pneumonectomies and biopsies were performed within 30 min of death at the bedside for histological examination, The results of the two techniques were compared with histological post-mortem lung examination or biopsies.Histological examination of the parenchyma showed signs of pneumonia in 14 cases. Lung tissue culture was positive in nine of these 14 cases. When ventilator-associated bacterial pneumonia was defined by the association of histological signs and positive lung tissue culture the sensitivity was 78% for both sampling techniques, specificity was 86% for mini-bronchoalveolar lavage and 100% for protected distal aspiration (at a threshold of 1 x 10(3) cfu.mL(-1)).Both techniques protected the distal aspiration and mini-bronchoalveolar lavage, and provided good specificity with an acceptable sensitivity for the diagnosis of ventilator-associated bacterial pneumonia.