Rigal E, Roze J C, Villers D, Derriennic M, David-Melon V, Lacroix-Mechinaud F, Mouzard A
Department of Pediatrics, University Hospital Center, Nantes, France.
Pediatr Pulmonol. 1990;8(4):268-72. doi: 10.1002/ppul.1950080411.
The precise diagnosis of lower respiratory tract infection in the critically ill newborn remains a difficult challenge. The bronchoscopic protected specimen brush (PSB) is a reliable method in intubated adults. Because the bronchoscopic procedure is not generally available for young children, Zucker proposed a blind technique for introducing the PSB into the distal airways. His results were promising but were not compared with any bacteriologic reference method. Therefore, we wanted to evaluate this technique in comparison with the open lung biopsy (OLB) when it could be ethically accomplished. Eleven PSB were collected simultaneously with an OLB. The sensitivity of the PSB procedure was 100%, its specificity 88%, its positive predictive value 66%, and its negative predictive value 100%. There were no complications secondary to the PSB procedure. In this short study, the PSB procedure using a blind technique is safe and feasible to obtain uncontaminated specimens in intubated and ventilated newborns, and is largely accurate in identifying the bacterial etiologic agent of lower respiratory tract infection.
危重新生儿下呼吸道感染的准确诊断仍然是一项艰巨的挑战。支气管镜保护性标本刷检（PSB）在插管成年患者中是一种可靠的方法。由于支气管镜检查一般不适用于幼儿，祖克提出了一种将PSB插入远端气道的盲法技术。他的结果很有前景，但未与任何细菌学参考方法进行比较。因此，我们希望在符合伦理的情况下，将该技术与开胸肺活检（OLB）进行比较评估。同时采集了11份PSB标本和1份OLB标本。PSB操作的敏感性为100%，特异性为88%，阳性预测值为66%，阴性预测值为100%。PSB操作未引发任何并发症。在这项简短的研究中，使用盲法技术的PSB操作对于在插管和通气的新生儿中获取未受污染的标本是安全可行的，并且在识别下呼吸道感染的细菌病原体方面基本准确。
