title: Comparison of nonbronchoscopic bronchoalveolar lavage to open lung biopsy for the bacteriologic diagnosis of pulmonary infections in mechanically ventilated patients.
abstract: We compared nonbronchoscopic bronchoalveolar lavage (NB-BAL) with open lung biopsy to determine the etiological diagnosis of lung infiltrates in patients requiring mechanical ventilation. NB-BAL was performed via a cuffed reusable 7F catheter generally used for right heart catheterization (BAL-C). In 13 patients, BAL-C and open lung biopsy were performed in the same lobe immediately after death when the ventilator was still functioning. No organism was cultured from BAL-C cultures when histopathologic examination of the lung showed no pneumonia and lung culture isolated no organism. Among the 10 positive BAL-C cultures, lung biopsy showed histologic pneumonia in 9 cases. Among these 9 pneumonia cases, 14 organisms were isolated in lung cultures and BAL-C correctly identified the causative agent in 13 cases. BAL-C appears to be an effective and safe procedure in the diagnosis of pulmonary infections in patients under mechanical ventilation who have previously received antibiotic therapy.
authors.affiliation: Department of Intensive Care, Hopital Croix Rousse, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Gaussorgues
authors.forename: D
authors.initials: D
authors.lastname: Piperno
authors.forename: P
authors.initials: P
authors.lastname: Bachmann
authors.forename: F
authors.initials: F
authors.lastname: Boyer
authors.forename: G
authors.initials: G
authors.lastname: Jean
authors.forename: M
authors.initials: M
authors.lastname: Gérard
authors.forename: P
authors.initials: P
authors.lastname: Léger
authors.forename: D
authors.initials: D
authors.lastname: Robert
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis*; D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D003428:Cross Infection / Q000175:diagnosis*; D006801:Humans; D008168:Lung / Q000473:pathology*; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis*; D012121:Respiration, Artificial; D007507:Therapeutic Irrigation / Q000295:instrumentation