title: Comparison of bronchoscopic bronchoalveolar lavage vs blind lavage with a modified nasogastric tube in the etiologic diagnosis of ventilator-associated pneumonia.
abstract: OBJECTIVE
  Our 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).
  
  
  METHODS
  Prospective 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.
  
  
  METHODS
  Single center study, with a 20 bed medical and surgical Intensive Care Unit of the University Hospital in Monterrey, Mexico.
  
  
  METHODS
  Twenty-five patients with high probability of VAP.
  
  
  METHODS
  Every patient underwent blind bronchoalveolar lavage with a modified nasogastric tube, and a bronchoscopic-guided bronchoalveolar lavage.
  
  
  RESULTS
  Twenty-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).
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Hospital Universitario Dr. José Eleuterio González, Monterrey, México.
authors.forename: A
authors.initials: A
authors.lastname: Leo
authors.forename: J
authors.initials: J
authors.lastname: Galindo-Galindo
authors.forename: E
authors.initials: E
authors.lastname: Folch
authors.forename: A
authors.initials: A
authors.lastname: Guerrero
authors.forename: F
authors.initials: F
authors.lastname: Bosques
authors.forename: R
authors.initials: R
authors.lastname: Mercado
authors.forename: A C
authors.initials: AC
authors.lastname: Arroliga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018893:Bronchoalveolar Lavage / Q000379:methods*; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000382:microbiology* / Q000628:therapy; D011446:Prospective Studies