Comparative Evaluation of the Role of Non-bronchoscopic vs Bronchoscopic Techniques for the Diagnosis of Ventilator-Associated Pneumonia
DOI:
https://doi.org/10.56056/Keywords:
Bronchoscopic Broncho alveolar lavage, non-Bronchoscopic protected Bronchoalveolar lavage, Ventilator-Associated PneumoniaAbstract
Background and objectives: Ventilator-associated pneumonia is a common form of hospital-acquired pneumonia that develops after 48 hours from intubation and mechanical ventilation. This study aims to compare the results of distal airway sampling for the diagnosis of Ventilator-Associated Pneumonia between Non-bronchoscopy and bronchoscopy Techniques.
Methods: This was a prospective case-control diagnostic study. The study was conducted over five months among patients with clinical suspicion of Ventilator Associated Pneumonia, who were admitted to the intensive care unit at Emergency Teaching Hospital and Azadi Teaching Hospital in Duhok City, from 1st May 2023 to 30th September 2023. We compared two methods of distal airway secretion to diagnose the infection: Non-Bronchoscopic protected Bronchoalveolar lavage and Bronchoscopic Broncho alveolar lavage.
Results: Acinetobacter baumanii (27.5%) was the most prevalent organism detected on Bronchoscopic Broncho alveolar lavage, followed by Klebsiella pneumonia 22.5% while on non-Bronchoscopic protected Bronchoalveolar lavage the most common organism detected was Klebsiella pneumonia (22.5%) followed by Acinetobacter baumanii (20%). Bronchoscopic Broncho alveolar lavage was more sensitive at 100% compared to 92.3% than non-Bronchoscopic protected Bronchoalveolar lavage, but the latter was more specific at 28.6% compared to 21.4%. additionally, the earlier was significantly associated with Clinical Pulmonary Infection Score, p-value 0.037, while the later was 0.129
Conclusion: ventilator associated pneumonia is a challenging diagnosis that requires clinical signs with suspicion followed by the appropriate laboratory diagnostic techniques. Both techniques were sensitive to Ventilator Associated Pneumonia detection, with Broncho alveolar lavage receiving a higher privilege.
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