USING BRONCHOALVEOLAR LAVAGE TO DISTINGUISH NOSOCOMIAL PNEUMONIA FROM SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
| Autor: | Gayle Minard, Martin A. Croce, F E Pritchard, Timothy C. Fabian, Kenneth A. Kudsk, Michael Schurr, Joe H. Patton, Boscarino R |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Colony Count Microbial Critical Care and Intensive Care Medicine Gastroenterology Diagnosis Differential Intensive care Internal medicine White blood cell medicine Pneumonia Bacterial Humans Prospective Studies Aged Cross Infection medicine.diagnostic_test Bacteria business.industry Respiratory disease Length of Stay Middle Aged medicine.disease Respiration Artificial Systemic Inflammatory Response Syndrome Surgery Anti-Bacterial Agents Systemic inflammatory response syndrome Pneumonia Bronchoalveolar lavage medicine.anatomical_structure Injury Severity Score Wounds and Injuries Female business Empiric therapy Bronchoalveolar Lavage Fluid |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 37:1012 |
| ISSN: | 0022-5282 |
| Popis: | Objective : Ventilator-associated pneumonia (PN) is difficult to distinguish from trauma-induced systemic inflammatory response syndrome (SIRS), especially in patients with multiple injuries. Previous work using bronchoscopy and quantitative cultures demonstrated significant bacterial growth in about one-third of patients with clinical evidence of PN. In this prospective study, antibiotic therapy for PN was based solely on quantitative bronchoalveolar lavage (BAL) cultures. Methods : Mechanically ventilated trauma patients underwent bronchoscopy with BAL when they developed clinical evidence of PN : fever (temperature > 100.5°F), white blood cells > 10,000 or >10% immature forms, purulent sputum, and new or changing infiltrate on chest roentgenogram. Patients with other infections or those receiving antibiotics for any other reason were excluded. Empiric antibiotic therapy for PN was started at the time of BAL. If the quantitative cultures revealed ≥10 5 colony-forming units (CFU)/mL, that patient was defined as having PN and was treated. If the cultures revealed |
| Databáze: | OpenAIRE |
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