| Is bilateral protected specimen brush sampling necessary for the accurate diagnosis of ventilator-associated pneumonia? | |
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MedLine Citation:
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PMID: 15345979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Clinical acumen alone is unreliable in establishing a diagnosis of ventilator-associated pneumonia (VAP) and controversy exists over which diagnostic tools should be utilized to confirm a clinical suspicion of VAP. The purpose of this study was to determine the reliability of blind protected specimen brush (PSB) sampling in the diagnosis of VAP and if bilateral PSB sampling is necessary. METHODS: Prospective study comparing blind PSB sampling with bronchoscopic directed PSB sampling in thirty-four consecutive SICU patients with a clinical suspicion of VAP. All patients underwent blind PSB sampling followed by bronchoscopic directed contralateral PSB sampling. RESULTS: Twenty-four of 34 patients (71%) were diagnosed to have VAP. The concordance rate between blind and directed PSB samples was 53% (18/34). When blind PSB was positive (15/34), the contralateral sample yielded a different microorganism in three patients (9%). When blind PSB was negative (19/34), infection was present in the contralateral lung in nine patients (26%). Blind PSB sampling alone was inaccurate in 35% of patients. CONCLUSIONS: The low concordance between blind and directed PSB suggests the need to sample both lung fields. Bilateral PSB sampling can identify unsuspected pathogenic microorganisms in the contralateral lung. |
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Authors:
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Karyn L Butler; Irwin M Best; Robert A Oster; Iva Katon-Benitez; Wm Lynn Weaver; Harvey L Bumpers |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Validation Studies |
Journal Detail:
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Title: The Journal of trauma Volume: 57 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-09-03 Completed Date: 2004-10-05 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 316-22 Citation Subset: AIM; IM |
Affiliation:
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Morehouse School of Medicine, Department of Surgery, Atlanta, Georgia 30310, USA. butlerk@msm.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Biopsy / economics, methods*, standards Bronchoalveolar Lavage Fluid / microbiology Bronchoscopy / economics, methods*, standards Cost-Benefit Analysis Cross Infection / diagnosis*, etiology Female Fever / microbiology Humans Length of Stay / statistics & numerical data Leukocytosis / microbiology Male Middle Aged Patient Selection Pneumonia, Bacterial / diagnosis*, etiology Prospective Studies Respiration, Artificial / adverse effects* Sensitivity and Specificity Specimen Handling / economics, methods*, standards Time Factors Wounds and Injuries / complications |
| Grant Support | |
ID/Acronym/Agency:
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2P20RR11104-06/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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