Blind use of the double-lumen plugged catheter for diagnosis of respiratory tract infections in critically ill children.

Transtracheal aspiration, percutaneous lung biopsy, and tracheal aspiration can be dangerous and/or unreliable methods for obtaining specimens of pulmonary secretions for culture. Using a blind technique, we evaluated the efficacy of a double-lumen catheter (DLC) with a polyethylene glycol plug in obtaining specimens of respiratory tract secretions for culture, and compared these results with simultaneously obtained cultures of tracheal aspirates. Twenty-seven intubated children already receiving antibiotic therapy were studied. Sixteen (59%) DLC specimens were sterile, as opposed to only 6 (22%) tracheal aspirates. Only 2 (8%) of the DLC specimens were contaminated. Two DLC specimens yielded significant bacterial growth (at least 10(5) colony-forming units/ml). Using DLC culture data, there was an 81% success rate in making decisions concerning antibiotic selection. We conclude that blind use of the DLC is a safe and reliable method of obtaining pulmonary secretion specimens for culture.