Abstract
Objectives
To demonstrate that blind insertion of the protected telescoping catheter (PTC-NB) through the orotracheal tube can provide reliable pulmonary samples for the diagnosis of nosocomial pneumonia (NP) in ventilated patients.
Design
We performed a random comparison between the protected telescoping catheter intoduced through a bronchofiberscope (PTC-B) and the PTC-NB to diagnose NP.Setting: A general intensive care unit of a University Hospital.
Patients
40 consecutive patients on mechanical ventilation and with suspicion of NP. The diagnosis of NP was suspected by clinical and chest X-ray findings.
Measurements and results
NP was confirmed microbiologically in 26 (65%) patients and maintained in 8 patients by clinical and radiological criteria. PTC-NB confirmed the microbiological diagnosis of PN in 21 (80%) patients. The use of antibiotics prior taking respiratory samples reduced the sensitivity of PTC-NB and PTC-B from 100–74% and from 94–70% (p=0.001). Both techniques agreed in 24 of 33 (73%) patients but such agreement was better when PN was on the right lung. Two patients developed a self-limiting hemoptysis after the PTC-B procedure.
Conclusions
PTC-NB is as sensitive as specific as PTC-B for diagnosing PN in mechanically ventilated patients, being a much easier technique to use.
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Jordá, R., Parras, F., Ibañez, J. et al. Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping catheter. Intensive Care Med 19, 377–382 (1993). https://doi.org/10.1007/BF01724876
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DOI: https://doi.org/10.1007/BF01724876