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At least 703 records · Page 39Linked to original sources
PubMed1991

Reliability of the bronchoscopic protected catheter brush in the diagnosis of pneumonia in mechanically ventilated patients.

OBJECTIVE: To assess the usefulness of the telescoping plugged catheter in the diagnosis of nosocomial pneumonia. DESIGN: Prospective study. PATIENTS: A total of 103 ventilated patients with suspected pneumonia were prospectively studied over 20 months. RESULTS: The quantitative cultures of the protected brush specimen detected pulmonary bacterial infection (greater than 10(3) cfu/mL) in 49 (47.5%) patients. Subsequent follow-up confirmed pneumonia in 41 patients; in only one patient was a positive protected brush specimen culture established as a false-positive result. There were 54 patients with less than 10(3) cfu/mL and the diagnosis was excluded in 36 of them. We identified eight patients with false-negative protected brush specimen cultures. The results obtained by this technique allowed us to modify treatment in 49 (47.5%) patients. CONCLUSIONS: The telescoping plugged catheter demonstrated significant bacterial infection in a relatively small proportion of patients in whom bacterial lung infection was suspected. This technique can be safely performed and is a sensitive and specific method to establish the cause of pneumonia, thus allowing specific treatment and the avoidance of inappropriate antibiotic therapy.

Adolescent↗
PubMed1996

The effect of introducing fibreoptic bronchoscopes on gas flow in laryngeal masks and tracheal tubes.

The laryngeal mask airway, reinforced laryngeal mask airway and tracheal tube were studied to determine (1) flow resistance during simulated inspiration and (2) the maximum size of fibreoptic scope which can be passed down the lumen at clinically useful ventilatory settings. In addition, the flow resistance imposed by the mask aperature bars was quantified. The laryngeal mask airway can accommodate a larger fibrescope than the corresponding sizes of reinforced laryngeal mask airway or tracheal tube. Mean (range) flow resistance was 2.3 (1.7-3.5) times higher with the reinforced laryngeal mask airway compared to the laryngeal mask airway, 2.1 (1.2-4.2) times higher with the tracheal tube compared with the laryngeal mask airway and 1.2 (0.7-1.8) times lower with the tracheal compared with the reinforced laryngeal mask airway. Removal of the mask aperture bars resulted in a mean decrease in flow resistance of 3.6%. Our data have shown that the laryngeal mask airway can accommodate a larger fibrescope than either the reinforced laryngeal mask airway or tracheal tube at clinically useful ventilatory settings and that the current recommendations for maximum size of fibrescope should be revised.

Airway Resistance↗