Ventilator associated pneumonia: quality of nonbronchoscopic bronchoalveolar lavage sample affects diagnostic yield
The importance of predefined criteria for acceptable samples of respiratory therapists′ obtained lower respiratory samples were studied, using a nonbronchoscopic bronchoalveolar lavage (BAL) protocol for ventilated patients in the intensive care unit. Therapists were instructed and asked to follow g...
Gespeichert in:
| Veröffentlicht in: | The European respiratory journal 2000-12, Vol.16 (6), p.1152-1157 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1157 |
|---|---|
| container_issue | 6 |
| container_start_page | 1152 |
| container_title | The European respiratory journal |
| container_volume | 16 |
| creator | Baughman, RP Spencer, RE Kleykamp, BO Rashkin, MC Douthit, MM |
| description | The importance of predefined criteria for acceptable samples of respiratory therapists′ obtained lower respiratory samples were studied, using a nonbronchoscopic bronchoalveolar lavage (BAL) protocol for ventilated patients in the intensive care unit.
Therapists were instructed and asked to follow guidelines for obtaining samples. Over one year, 219 samples were obtained by respiratory therapists. Of these, 115 were considered to be adequate samples using the following criteria: 60 mL of instilled volume, at least 5 mL of fluid aspirated, specimens sent for semiquantitative culture, a differential cell count of 10,000 colony forming units (cfu)·mL‐1 of BAL. The most common pathogen was Staphylococcus aureus (S. aureus) (11 samples), although Gram‐negative bacilli were the single pathogen in 21 specimens. Of the 115 acceptable samples, 40 (35%) grew ≥1 pathogen at >10,000 cfu·mL‐1. For the 80 not acceptable samples which were sent for appropriate culture, 12 (15%) grew >10,000 cfu·mL‐1 BAL. This difference was significant (Chi‐squared=9.44, p |
| doi_str_mv | 10.1034/j.1399-3003.2000.16f23.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72589863</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>72589863</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4563-77e400b852989be0126e38393ad36a996ac9a3ea3087690ac5ea7e616461c10b3</originalsourceid><addsrcrecordid>eNqNkE1v1DAQhi0EokvhLyBLSNyy9cfGiTkgoaqFokpICLhaE2ey65UTp3bSdv89XjZqr5wse57XM_MQQjlbcyY3F_s1l1oXkjG5FozlV9UJuX58QVZPhZdkxTSTBddSnZE3Ke0Z42oj-WtyxrnQgguxIukPDpPzMIVIIaVgHUzY0nHAuQ-Dg0_0bgbvpgMNHR3C0MQw2F1INozO0uUG_h6Dh0g93MMWaYJ-9Eih69BOibYOtkNIUw4cHPr2LXnVgU_4bjnPye_rq1-X34rbH19vLr_cFnZTKllUFW4Ya-pS6Fo3yLhQKGupJbRSgdYKrAaJIFldKc3AlggVqryj4pazRp6Tj6d_xxjuZkyT6V2y6D0MGOZkKlHWulYyg_UJtDGkFLEzY3Q9xIPhzByFm705ejVHr-Yo3PwTbh5z9P3SY256bJ-Di-EMfFgASBZ8F2GwLj1xmile6Ux9PlEPzuPhv9ubq5_fuboW8nnXndvuHlxEk3rwPk_FDcY9V0blmUoh_wLDzas-</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72589863</pqid></control><display><type>article</type><title>Ventilator associated pneumonia: quality of nonbronchoscopic bronchoalveolar lavage sample affects diagnostic yield</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Baughman, RP ; Spencer, RE ; Kleykamp, BO ; Rashkin, MC ; Douthit, MM</creator><creatorcontrib>Baughman, RP ; Spencer, RE ; Kleykamp, BO ; Rashkin, MC ; Douthit, MM</creatorcontrib><description>The importance of predefined criteria for acceptable samples of respiratory therapists′ obtained lower respiratory samples were studied, using a nonbronchoscopic bronchoalveolar lavage (BAL) protocol for ventilated patients in the intensive care unit.
Therapists were instructed and asked to follow guidelines for obtaining samples. Over one year, 219 samples were obtained by respiratory therapists. Of these, 115 were considered to be adequate samples using the following criteria: 60 mL of instilled volume, at least 5 mL of fluid aspirated, specimens sent for semiquantitative culture, a differential cell count of <5% bronchial epithelial cells.
Overall, 52 samples grew one or more pathogen at >10,000 colony forming units (cfu)·mL‐1 of BAL. The most common pathogen was Staphylococcus aureus (S. aureus) (11 samples), although Gram‐negative bacilli were the single pathogen in 21 specimens. Of the 115 acceptable samples, 40 (35%) grew ≥1 pathogen at >10,000 cfu·mL‐1. For the 80 not acceptable samples which were sent for appropriate culture, 12 (15%) grew >10,000 cfu·mL‐1 BAL. This difference was significant (Chi‐squared=9.44, p<0.01).
Nonbronchoscopic bronchoalveolar lavage can be safely performed by respiratory therapists′. The authors recommend that a protocol be used to evaluate the quality of a bronchoalveolar lavage sample in the same manner sputum samples are screened prior to interpretation.</description><identifier>ISSN: 0903-1936</identifier><identifier>EISSN: 1399-3003</identifier><identifier>DOI: 10.1034/j.1399-3003.2000.16f23.x</identifier><identifier>PMID: 11292122</identifier><language>eng</language><publisher>Sheffield: Eur Respiratory Soc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bronchoalveolar lavage ; Bronchoalveolar Lavage Fluid - microbiology ; Bronchoscopy ; Colony Count, Microbial ; Cross Infection - diagnosis ; Cross Infection - microbiology ; Emergency and intensive respiratory care ; Gram-Negative Bacteria - isolation & purification ; Humans ; Intensive care medicine ; Intensive Care Units ; Medical sciences ; nosocomial infection ; pneumonia ; Pneumonia, Bacterial - diagnosis ; Pneumonia, Bacterial - microbiology ; Predictive Value of Tests ; respiratory therapy ; Staphylococcus aureus - isolation & purification ; Ventilators, Mechanical</subject><ispartof>The European respiratory journal, 2000-12, Vol.16 (6), p.1152-1157</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4563-77e400b852989be0126e38393ad36a996ac9a3ea3087690ac5ea7e616461c10b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1034%2Fj.1399-3003.2000.16f23.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=906179$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11292122$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baughman, RP</creatorcontrib><creatorcontrib>Spencer, RE</creatorcontrib><creatorcontrib>Kleykamp, BO</creatorcontrib><creatorcontrib>Rashkin, MC</creatorcontrib><creatorcontrib>Douthit, MM</creatorcontrib><title>Ventilator associated pneumonia: quality of nonbronchoscopic bronchoalveolar lavage sample affects diagnostic yield</title><title>The European respiratory journal</title><addtitle>Eur Respir J</addtitle><description>The importance of predefined criteria for acceptable samples of respiratory therapists′ obtained lower respiratory samples were studied, using a nonbronchoscopic bronchoalveolar lavage (BAL) protocol for ventilated patients in the intensive care unit.
Therapists were instructed and asked to follow guidelines for obtaining samples. Over one year, 219 samples were obtained by respiratory therapists. Of these, 115 were considered to be adequate samples using the following criteria: 60 mL of instilled volume, at least 5 mL of fluid aspirated, specimens sent for semiquantitative culture, a differential cell count of <5% bronchial epithelial cells.
Overall, 52 samples grew one or more pathogen at >10,000 colony forming units (cfu)·mL‐1 of BAL. The most common pathogen was Staphylococcus aureus (S. aureus) (11 samples), although Gram‐negative bacilli were the single pathogen in 21 specimens. Of the 115 acceptable samples, 40 (35%) grew ≥1 pathogen at >10,000 cfu·mL‐1. For the 80 not acceptable samples which were sent for appropriate culture, 12 (15%) grew >10,000 cfu·mL‐1 BAL. This difference was significant (Chi‐squared=9.44, p<0.01).
Nonbronchoscopic bronchoalveolar lavage can be safely performed by respiratory therapists′. The authors recommend that a protocol be used to evaluate the quality of a bronchoalveolar lavage sample in the same manner sputum samples are screened prior to interpretation.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bronchoalveolar lavage</subject><subject>Bronchoalveolar Lavage Fluid - microbiology</subject><subject>Bronchoscopy</subject><subject>Colony Count, Microbial</subject><subject>Cross Infection - diagnosis</subject><subject>Cross Infection - microbiology</subject><subject>Emergency and intensive respiratory care</subject><subject>Gram-Negative Bacteria - isolation & purification</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units</subject><subject>Medical sciences</subject><subject>nosocomial infection</subject><subject>pneumonia</subject><subject>Pneumonia, Bacterial - diagnosis</subject><subject>Pneumonia, Bacterial - microbiology</subject><subject>Predictive Value of Tests</subject><subject>respiratory therapy</subject><subject>Staphylococcus aureus - isolation & purification</subject><subject>Ventilators, Mechanical</subject><issn>0903-1936</issn><issn>1399-3003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1v1DAQhi0EokvhLyBLSNyy9cfGiTkgoaqFokpICLhaE2ey65UTp3bSdv89XjZqr5wse57XM_MQQjlbcyY3F_s1l1oXkjG5FozlV9UJuX58QVZPhZdkxTSTBddSnZE3Ke0Z42oj-WtyxrnQgguxIukPDpPzMIVIIaVgHUzY0nHAuQ-Dg0_0bgbvpgMNHR3C0MQw2F1INozO0uUG_h6Dh0g93MMWaYJ-9Eih69BOibYOtkNIUw4cHPr2LXnVgU_4bjnPye_rq1-X34rbH19vLr_cFnZTKllUFW4Ya-pS6Fo3yLhQKGupJbRSgdYKrAaJIFldKc3AlggVqryj4pazRp6Tj6d_xxjuZkyT6V2y6D0MGOZkKlHWulYyg_UJtDGkFLEzY3Q9xIPhzByFm705ejVHr-Yo3PwTbh5z9P3SY256bJ-Di-EMfFgASBZ8F2GwLj1xmile6Ux9PlEPzuPhv9ubq5_fuboW8nnXndvuHlxEk3rwPk_FDcY9V0blmUoh_wLDzas-</recordid><startdate>200012</startdate><enddate>200012</enddate><creator>Baughman, RP</creator><creator>Spencer, RE</creator><creator>Kleykamp, BO</creator><creator>Rashkin, MC</creator><creator>Douthit, MM</creator><general>Eur Respiratory Soc</general><general>Munksgaard International Publishers</general><general>Maney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200012</creationdate><title>Ventilator associated pneumonia: quality of nonbronchoscopic bronchoalveolar lavage sample affects diagnostic yield</title><author>Baughman, RP ; Spencer, RE ; Kleykamp, BO ; Rashkin, MC ; Douthit, MM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4563-77e400b852989be0126e38393ad36a996ac9a3ea3087690ac5ea7e616461c10b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Bronchoalveolar lavage</topic><topic>Bronchoalveolar Lavage Fluid - microbiology</topic><topic>Bronchoscopy</topic><topic>Colony Count, Microbial</topic><topic>Cross Infection - diagnosis</topic><topic>Cross Infection - microbiology</topic><topic>Emergency and intensive respiratory care</topic><topic>Gram-Negative Bacteria - isolation & purification</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units</topic><topic>Medical sciences</topic><topic>nosocomial infection</topic><topic>pneumonia</topic><topic>Pneumonia, Bacterial - diagnosis</topic><topic>Pneumonia, Bacterial - microbiology</topic><topic>Predictive Value of Tests</topic><topic>respiratory therapy</topic><topic>Staphylococcus aureus - isolation & purification</topic><topic>Ventilators, Mechanical</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baughman, RP</creatorcontrib><creatorcontrib>Spencer, RE</creatorcontrib><creatorcontrib>Kleykamp, BO</creatorcontrib><creatorcontrib>Rashkin, MC</creatorcontrib><creatorcontrib>Douthit, MM</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The European respiratory journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baughman, RP</au><au>Spencer, RE</au><au>Kleykamp, BO</au><au>Rashkin, MC</au><au>Douthit, MM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventilator associated pneumonia: quality of nonbronchoscopic bronchoalveolar lavage sample affects diagnostic yield</atitle><jtitle>The European respiratory journal</jtitle><addtitle>Eur Respir J</addtitle><date>2000-12</date><risdate>2000</risdate><volume>16</volume><issue>6</issue><spage>1152</spage><epage>1157</epage><pages>1152-1157</pages><issn>0903-1936</issn><eissn>1399-3003</eissn><abstract>The importance of predefined criteria for acceptable samples of respiratory therapists′ obtained lower respiratory samples were studied, using a nonbronchoscopic bronchoalveolar lavage (BAL) protocol for ventilated patients in the intensive care unit.
Therapists were instructed and asked to follow guidelines for obtaining samples. Over one year, 219 samples were obtained by respiratory therapists. Of these, 115 were considered to be adequate samples using the following criteria: 60 mL of instilled volume, at least 5 mL of fluid aspirated, specimens sent for semiquantitative culture, a differential cell count of <5% bronchial epithelial cells.
Overall, 52 samples grew one or more pathogen at >10,000 colony forming units (cfu)·mL‐1 of BAL. The most common pathogen was Staphylococcus aureus (S. aureus) (11 samples), although Gram‐negative bacilli were the single pathogen in 21 specimens. Of the 115 acceptable samples, 40 (35%) grew ≥1 pathogen at >10,000 cfu·mL‐1. For the 80 not acceptable samples which were sent for appropriate culture, 12 (15%) grew >10,000 cfu·mL‐1 BAL. This difference was significant (Chi‐squared=9.44, p<0.01).
Nonbronchoscopic bronchoalveolar lavage can be safely performed by respiratory therapists′. The authors recommend that a protocol be used to evaluate the quality of a bronchoalveolar lavage sample in the same manner sputum samples are screened prior to interpretation.</abstract><cop>Sheffield</cop><pub>Eur Respiratory Soc</pub><pmid>11292122</pmid><doi>10.1034/j.1399-3003.2000.16f23.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0903-1936 |
| ispartof | The European respiratory journal, 2000-12, Vol.16 (6), p.1152-1157 |
| issn | 0903-1936 1399-3003 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72589863 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Bronchoalveolar lavage Bronchoalveolar Lavage Fluid - microbiology Bronchoscopy Colony Count, Microbial Cross Infection - diagnosis Cross Infection - microbiology Emergency and intensive respiratory care Gram-Negative Bacteria - isolation & purification Humans Intensive care medicine Intensive Care Units Medical sciences nosocomial infection pneumonia Pneumonia, Bacterial - diagnosis Pneumonia, Bacterial - microbiology Predictive Value of Tests respiratory therapy Staphylococcus aureus - isolation & purification Ventilators, Mechanical |
| title | Ventilator associated pneumonia: quality of nonbronchoscopic bronchoalveolar lavage sample affects diagnostic yield |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T12%3A50%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ventilator%20associated%20pneumonia:%20quality%20of%20nonbronchoscopic%20bronchoalveolar%20lavage%20sample%20affects%20diagnostic%20yield&rft.jtitle=The%20European%20respiratory%20journal&rft.au=Baughman,%20RP&rft.date=2000-12&rft.volume=16&rft.issue=6&rft.spage=1152&rft.epage=1157&rft.pages=1152-1157&rft.issn=0903-1936&rft.eissn=1399-3003&rft_id=info:doi/10.1034/j.1399-3003.2000.16f23.x&rft_dat=%3Cproquest_cross%3E72589863%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=72589863&rft_id=info:pmid/11292122&rfr_iscdi=true |