The Consistency and Clinical Significance between Bronchoscopic Samples and Endotracheal or Tracheostomic Aspirates in Severe Pneumonia Under Mechanical Ventilation.
10.4266/kjccm.2011.26.2.83
- Author:
Hye Sung PARK
1
;
Seo Woo KIM
;
Yun Su SIM
;
Ji Hye KIM
;
Yon Ju RYU
;
Jin Hwa LEE
;
Jung Hyun CHANG
Author Information
1. Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. hs1017@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
bronchoscopic;
endotracheal aspirates;
mechanical ventilation;
pneumonia
- MeSH:
Bronchoscopy;
Colon;
Female;
Humans;
Intensive Care Units;
Length of Stay;
Pneumonia;
Respiration, Artificial;
Retrospective Studies;
Risk Factors;
Tracheostomy
- From:The Korean Journal of Critical Care Medicine
2011;26(2):83-88
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Distal airway bacterial colonization occurs more frequently in patients with endotracheal tubes or tracheostomy of intensive care units (ICU) care. In general, bronchoscopic samples are considered more accurate than transtracheal aspirates. In this study, we evaluated the consistency and clinical significance between bronchoscopic samples and transtracheal aspirates (TTA) in severe pneumonia under mechanical ventilation. METHODS: We investigated the consistency between bronchoscopic samples and transtracheal aspirates among patients with endotracheal tubes or tracheostomy, retrospectively. Fiberoptic bronchoscopy was performed in 212 patients with mechanical ventilation via endotracheal tube or tracheostomy between January 1st, 2004 and December 31th, 2008 in ICU at Ewha Womans University Hospital. We evaluated consistency in terms of true pathogen according to the arbitrary ICU days progress. RESULTS: Among the 212 enrolled patients, 113 (53%) had consistency between bronchoscopic samples and transtracheal aspirates. When evaluated alteration trends in consistency according to ICU stay, the consistency was maintained for 5 to 9 ICU days with statistical significance (p< 0.05) since adjusting for age, sex, and combined risk factors. Consistency in sampling status between the endotracheal tube and tracheostomy was also evaluated, however, there was no statistical significance (OR 1.9 vs. 1, 95% CI = 0.997-3.582, p = 0.051). CONCLUSIONS: Shorter hospital stay (within 9 days of ICU stay) had higher probability of consistency between bronchoscopic samples and TTA samples. TTA may be as confident as bronchoscopic samples in patients of pneumonia under mechanical ventilation with shorter ICU stays, especially less than 10 days.
