Gutiérrez CA, Montelongo FJ, Suárez SA, Trujillo MM, Huerta RV, Flores PC

Language: Spanish
References: 9
Page: 589-593
PDF size: 294.34 Kb.

ABSTRACT

Introduction: for the diagnosis of ventilator-associated pneumonia, a culture of bronchial secretion obtained by bronchoalveolar lavage by bronchoscopy as well as by tracheal aspiration is required. This specimen must be satisfactory (not contaminated) for culture of that secretion, which is defined as a sample containing more than 25 polymorphonuclear leukocytes and less than 10 epithelial cells per low-power field and a positive qualitative, semiquantitative or quantitative culture, depending on where the sample is obtained, whether directly from the bronchus or the trachea. Objective: to determine the diagnostic effectiveness of bronchoalveolar lavage vs tracheal aspiration in critically ill patients with suspected ventilator-associated pneumonia and to assess the performance of both tests. Material and methods: a prospective, cross-sectional, descriptive and analytical study was conducted in the intensive care unit of the General Hospital "Las Américas" of the Health Institute of the State of Mexico. Results: the quality of the sample obtained by bronchoalveolar lavage was better than that obtained by tracheal aspiration and was statistically significant in the number of epithelial cells, which shows that the aliquot was not contaminated with upper airway secretions (p = 0.001). Bronchoalveolar lavage by bronchoscopy was more effective in diagnosing ventilator-associated pneumonia, since it identified 91% of the cases (n = 22) while tracheal aspiration only identified 33.3% (n = 8). This difference was statistically significant (p = 0.0001) through quantitative cultures in colony-forming units, obtained in bacterial growth media. Conclusion: bronchial secretion cultures obtained with bronchoalveolar lavage by bronchoscopy are more effective in diagnosing ventilator-associated pneumonia.

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