Piperno D, Gaussorgues P, Valon B, Payré J, Fouque P, Robert D
Rev Mal Respir. 1987;4(1):17-21.
73 patients on artificial ventilation and presenting with localised or diffuse consolidation had broncho-alveolar lavage (LBA), in search for a causative organism, in a prospective fashion. LBA was done using a supple balloon catheter (LBA-c) which was placed blind down the intubation tube, until a distal bronchus was blocked (under radiographic control). The mean number of organisms found was 1.56 +/- 1.2. LBA-c alone provided a diagnosis in 31 cases (42%) and in association with blood cultures in 14 cases (19%). In 11 cases (15%) the consolidation was not caused by infection. In 14 cases (19%) the diagnosis was made by serology or blood cultures alone. Finally in 8 cases (11%) no diagnosis could be made. Thus LBA-c achieved an etiological diagnosis for the pneumonia in 45 cases (54.8%) and remained negative in non-infectious cases. The good tolerance of the technique as regards blood gases, its simplicity of operation (without a fibrescope) and its diagnostic reproducibility make LBA-c an option in the diagnosis of pneumonias on artificial ventilation.
73例接受人工通气且出现局限性或弥漫性实变的患者前瞻性地进行了支气管肺泡灌洗(LBA),以寻找致病微生物。LBA采用柔软的球囊导管(LBA-c)进行,该导管经气管插管盲目置入,直至在影像学控制下阻塞远端支气管。发现的微生物平均数量为1.56±1.2。仅LBA-c在31例(42%)中提供了诊断,与血培养联合在14例(19%)中提供了诊断。11例(15%)的实变不是由感染引起的。14例(19%)仅通过血清学或血培养做出诊断。最后,8例(11%)无法做出诊断。因此,LBA-c在45例(54.8%)中实现了肺炎的病因诊断,在非感染性病例中结果为阴性。该技术对血气的良好耐受性、操作简单(无需纤维支气管镜)及其诊断可重复性使LBA-c成为人工通气患者肺炎诊断的一种选择。