[The diagnosis of pneumonia in the ventilated patient].
The diagnosis of ventilator-associated pneumonia is difficult to confirm because the usual clinical criteria lack predictive value. Risk factors evaluated recently serve to assess subgroups of exposed patients. Bronchoscopic bronchoalveolar lavage (BAL) or protected specimen brush, together with quantitative bacteriology, are the present method of choice for diagnosis of nosocomial pneumonia during mechanical ventilation. Nonbronchoscopic "blind" BAL catheters provide new, attractive, accurate and easy sampling techniques. This could become the technique of choice in the future. Efforts are needed to standardize diagnostic criteria, in order to allow comparisons between groups of patients or clinical trials for prevention or treatment of ventilator-associated pneumonia.
Pugin
J
J
Clinique médicale thérapeutique, Hôpital cantonal universitaire, Genève.
D001431:Bacteriological Techniques; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D001995:Bronchography; D006801:Humans; D011014:Pneumonia / Q000175:diagnosis* / Q000382:microbiology; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors; D013048:Specimen Handling / Q000379:methods; D014132:Trachea / Q000378:metabolism
Le diagnostic de la pneumonie chez le patient ventilé.