The American Journal of Surgery
Volume 195, Issue 2 , Pages 159-163 , February 2008

Utility of bilateral bronchoalveolar lavage for the diagnosis of ventilator-associated pneumonia in critically ill surgical patients

  • Sha-Ron Jackson, M.D.

      Affiliations

    • Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, P.O. Box 670558, Cincinnati, OH 45264, USA
    • ,
  • Neil E. Ernst, Pharm.D.

      Affiliations

    • Division of Pharmacy Practice, University of Cincinnati, 3225 Eden Avenue, 136 Health Professions Building, Cincinnati, OH 45267, USA
    • Department of Pharmacy Services, The University Hospital, 234 Goodman Street, Cincinnati, OH 45219, USA
    • ,
  • Eric W. Mueller, Pharm.D.

      Affiliations

    • Division of Pharmacy Practice, University of Cincinnati, 3225 Eden Avenue, 136 Health Professions Building, Cincinnati, OH 45267, USA
    • Department of Pharmacy Services, The University Hospital, 234 Goodman Street, Cincinnati, OH 45219, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-513-558-8931; fax: +1-513-558-0546.
    • ,
  • Karyn L. Butler, M.D.

      Affiliations

    • Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, P.O. Box 670558, Cincinnati, OH 45264, USA
    • Division of Trauma/Critical Care, University of Cincinnati, 231 Albert Sabin Way, G933, Cincinnati, OH 45267, USA

Received 16 July 2007 ,Revised 20 September 2007

References 

  1. Tablan OC, Anderson LJ, Besser R, et al. Healthcare Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention (Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of the CDC and the Healthcare Infection Control Practices Advisory Committee). MMWR Recomm Rep. 2004;53(RR-3):1–36
  2. Official statement of the American Thoracic Society and the Infectious Diseases Society of America (Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia). Am J Respir Crit Care Med. 2005;171:388–416
  3. Fabregas N, Ewig S, Torres A, El-Ebiary M, et al. Clinical diagnosis of ventilator associated pneumonia revisited: comparative validation using immediate post-mortem lung biopsies. Thorax. 1999;54:867–873
  4. Wunderink RG. Clinical criteria in the diagnosis of ventilator-associated pneumonia. Chest. 2000;117(4 suppl 2):191S–194S
  5. Croce MA, Fabian TC, Waddle-Smith L, et al. Utility of Gram’s stain and efficacy of quantitative cultures for posttraumatic pneumonia: a prospective study. Ann Surg. 1998;227(5):743–755
  6. Kirtland SH, Corley DE, Winterbauer RH, et al. The diagnosis of ventilator-associated pneumonia: a comparison of histologic, microbiologic, and clinical criteria. Chest. 1997;112:445–457
  7. Wermert D, Marquette CH, Copin MC, et al. Influence of pulmonary bacteriology and histology on the yield of diagnostic procedures in ventilator-acquired pneumonia. Am J Respir Crit Care Med. 1998;158:139–147
  8. Rouby JJ, Martin DL, Poete P, et al. Nosocomial bronchopneumonia in the critically ill: histologic and bacteriologic aspects. Am Rev Respir Dis. 1992;146:1059–1066
  9. Trouillet JL, Guiguet M, Gibert C, et al. Fiberoptic bronchoscopy in ventilated patients: evaluation of cardiopulmonary risk under midazolam sedation. Chest. 1990;97:8927–8933
  10. Baughman RP. Protected specimen brush technique in the diagnosis of ventilator-associated pneumonia. Chest. 2000;117:203S–206S
  11. Fagon JY, Chastre J, Wolff M, et al. Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia (A randomized trial). Ann Intern Med. 2000;132(8):621–630Apr 18
  12. Croce MA, Fabian TC, Shaw B, et al. Analysis of charges associated with diagnosis of nosocomial pneumonia: can routine bronchoscopy be justified?. J Trauma. 1994;37(5):721–727
  13. Wunderink RG, Woldenberg LS, Zeiss J, et al. The radiologic diagnosis of autopsy proven ventilator-associated pneumonia. Chest. 1992;101:458–463
  14. Minei JP, Nathens AB, West M, et al. Inflammation and the Host Response to Injury Large Scale Collaborative Research Program Investigators Inflammation and the Host Response to Injury, a Large-Scale Collaborative Project: patient-oriented research core-standard operating procedures for clinical care. II. Guidelines for prevention, diagnosis and treatment of ventilator-associated pneumonia (VAP) in the trauma patient. J Trauma. 2006;60(5):1106–1113
  15. Butler KL, Sinclair KE, Henderson VJ, et al. The chest radiograph in critically ill surgical patients is inaccurate in predicting ventilator-associated pneumonia. Am Surg. 1999;65:805–810
  16. Ibrahim EH, Sherman G, Ward S, et al. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000;118:146–155
  17. Alvarez-Lerma F ICU-Acquired Pneumonia Study Group. Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit. Intensive Care Med. 1996;22:387–394
  18. Luna CM, Vujacich P, Niederman MS, et al. Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia. Chest. 1997;111:676–685
  19. Rello J, Ollendorf DA, Oster G, et al. VAP Outcomes Scientific Advisory Group. Chest. 2002;122:2115–2121

PII: S0002-9610(07)00828-8

doi: 10.1016/j.amjsurg.2007.09.030

The American Journal of Surgery
Volume 195, Issue 2 , Pages 159-163 , February 2008

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