VALUE OF BRONCHOSCOPIC PNEUMONIA DIAGNOSIS - PROSPECTIVE-STUDY

In a prospective clinical study we examined whether bronchoscopically controlled suctioning is preferable to the blind suctioning of mucus a spirates for bacterial identification of intensive care unit patients with pneumonia. Forty patients with clinical and radiologic signs of p neumonia underwent both bronchoscopically controlled and blind endotra cheal lavage. Bronchoscopically controlled suctioning did not demonstr ate greater sensitivity for identifying organisms than the results obt ained from blind suctioning (58 organism were bronchoscopically identi fied, compared to 57 organisms identified by blind suctioning; p = 0.3 2, NS). Arterial and mixed venous partial oxygen pressure and shunt al so shelved no significant differences 15 minutes before and after exam ination, nor did the blood pressure or pulse. The use of four of the b ronchoscopes resulted in preinter entional contamination with Pseudomo nas. Bronchoscopically controlled lavage shows no advantages over blin d endotracheal lavage for diagnosing pneumonia. Blind suctioning with single-use sterile catheters can be done more quickly and inexpensivel y with fewer personnel and a lower complication rate.