PATHOLOGICAL, BACTERIOLOGICAL, AND NON-INVASIVE CARDIOPULMONARY EVALUATION OF PROTECTED BRONCHOALVEOLAR LAVAGE (PRO-BAL) IN RESPIRATORY CRITICALLY ILL PATIENTS

Abstract

Nosocomial pneumonia is the second most common nosocomial infection and is the nosocomial infection with the highest case/fatality ratio. Unfortunately, past studies of nosocomial pneumonia, particularly ventilator-associated pneumonia (VAP), have been plagued by uncertainty regarding the accuracy of diagnosis based on clinical and roentgenographic criteria and culture of endotracheal secretions. Further, endotracheal intubation leads to contamination of tracheal secretions with bacteria that colonize the upper respiratory tract. Recently, several studies have suggested that the use of quantitative cultures of endotracheal aspirates (QEA) may have a similar diagnostic value compared with invasive techniques such as protected specimen brush (PSB) and

bronchoalveolar lavage (BAL). The accurate diagnosis of ventilator-associated

pneumonia (VAP) remains controversial.