文摘
院内肺炎的病原学的诊断重症监护病房(ICU)患者需要一个有效的,便宜又安全的方法。这种方法应该适用于所有和所有icu机械通气病人。本研究的目的是评估三种方法的诊断收益率:“盲目”支气管刷(Accu-Cath)(保护标本brush-nonbronchofibroscopic (PSB-non BF));bronchofibroscopic保护标本刷牙(PSB-BF)和支气管肺泡灌洗(BAL)。我们前瞻性研究的三种方法的诊断价值以及微生物结果之间的协议在74年88事件的患者与机械通气相关肺炎(VAP)和临床疑似22对照组。VAP集也分为无抗生素(n = 24)和预处理(n = 64)、和那些(n = 78),没有(n = 10)对下叶浸润胸片。没有发现差异的细菌产生的三个技巧。此外,整合结果的速率高;92% PSB-BF落下帷幕;84% PSB-nonBF落下帷幕; 85% for PSB-nonBF and PSB-BF; and 85% for PSB-nonBF combined with both bronchoscopic techniques. The diagnostic yields in suspected VAP were 66, 59 and 56% for PSB-nonBF, PSB-BF and BAL, respectively. We conclude that "blind" bronchial brushing has similar accuracy to bronchoscopic techniques commonly used in the diagnosis of ventilator-associated pneumonia, constituting an interesting alternative in hospitals where fibreoptic bronchoscopy is not available.