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Therapeutic Methods and Therapies TCIM
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Harefuah ; 155(2): 105-9, 131, 2016 Feb.
Article in Hebrew | MEDLINE | ID: mdl-27215123

ABSTRACT

BACKGROUND: Ventilator associated pneumonia (VAPI is a common complication leading to lengthier hospitalizations and higher mortality. Prompt adequate initial antibiotic coverage is the crucial issue affecting survival. Currently, there is no gold standard diagnostic test. No conclusive data regarding the benefit of bronchoscopy exists in the literature reviewed. AIM: This study aims to evaluate the change of prognosis for patients who developed VAP, following a positive culture from bronchoalveolar lavage (BAL). DESIGN: This is a retrospective cohort study. SETTING: General intensive care unit in a tertiary university healthcare center. PARTICIPANTS: All patients who were admitted to Surgical ICU and developed VAP and who then underwent diagnostic bronchoscopy with BAL between the period 01/02/2007 - 31/02/2011. MEASUREMENTS AND RESULTS: A total of 66 patients who were admitted to the ICU, developed VAP and underwent bronchoscopy while ventilated; 30 patients were excluded. The positive BAL culture group was compared to the negative BAL culture group; there was no difference between demographic and clinical characteristics, mortality rates (for 30 days) or therapy change between the two groups. No complications were reported regarding the bronchoscopy procedure. CONCLUSIONS: Our findings demonstrate that performing y a diagnostic bronchoscopy with BAL does not improve the prognosis of patients with VAP. Furthermore, expanded prospective studies will be needed to conclude regarding its benefit in diagnosis and subsequent rectifying of therapy.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bronchoscopy/methods , Pneumonia, Ventilator-Associated/diagnosis , Adult , Aged , Bronchoalveolar Lavage/methods , Bronchoalveolar Lavage Fluid/microbiology , Cohort Studies , Female , Humans , Intensive Care Units/statistics & numerical data , Israel/epidemiology , Male , Microbial Sensitivity Tests/methods , Middle Aged , Outcome Assessment, Health Care , Patient Selection , Pneumonia, Ventilator-Associated/microbiology , Pneumonia, Ventilator-Associated/mortality , Pneumonia, Ventilator-Associated/therapy , Predictive Value of Tests , Prognosis , Reproducibility of Results , Retrospective Studies , Tertiary Care Centers/statistics & numerical data
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