Value of bronchoalveolar lavage in the diagnosis of newly developed lung infiltrates in mechanically ventilated patients

Abstract

Background and objectives Cost-effectiveness is a significant concern in a developing economy. As a result, the purpose of this work was to study the efficiency and safety of using mini bronchoalveolar lavage (mini-BAL) samples to diagnose recently developed lung infiltrates in mechanically ventilated patients. Aims This work aims to evaluate the role of BAL cultures sampled using the mini-BAL maneuver to diagnose recently developed lung infiltrates in patients who are being ventilated mechanically. Patients and methods Mini-BAL and microbiological cultures were to evaluate 30 mechanically ventilated patients with recently developed lung infiltrates. The outer protective catheter was a Nelaton catheter size 18 FG, while the inner catheter was an infant ryle catheter size FG-10. Instead of using the prepackaged catheters, the outer protective catheter was blocked by sterile K-Y gel. Results Klebsiella spp. are the most commonly isolated bacterial (44.4%) while Candida spp. (23.3%) are the most commonly isolated fungal organism in mechanically ventilated patients. Some patients had more than one isolated organism: Bimicrobial 16.7% and polymicrobial 26.7% while unimicrobial 46.7%. There was a statistically significant relationship between microbiology and clinical pulmonary infection score among the included patients at P value of 0.003. Conclusion The new mini-BAL is an effective bedside maneuver for obtaining uncontaminated lower respiratory secretions in patients with recently developed pulmonary infiltrates and suspected ventilator-associated pneumonia. It is also safe, affordable, easy, noninvasive, and readily available.

Keywords

• bimicrobial
• mini bronchoalveolar lavage
• polymicrobial
• unimicrobial
• ventilator-associated pneumonia