Non-directed bronchial lavage is a safe method for sampling the respiratory tract in critically ill patientCitation formats

  • External authors:
  • B. V. Bonvento
  • J. A. Rooney
  • M. O. Columb

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Non-directed bronchial lavage is a safe method for sampling the respiratory tract in critically ill patient. / Bonvento, B. V.; Rooney, J. A.; Columb, M. O.; McGrath, B. A.; Bentley, A. M.; Felton, T. W.

In: Journal of the Intensive Care Society, 13.11.2018.

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@article{952c22e60d1a4517adefd1d913c23221,
title = "Non-directed bronchial lavage is a safe method for sampling the respiratory tract in critically ill patient",
abstract = "Ventilated patients are at risk of acquiring ventilator-associated pneumonia. Various techniques are available for diagnosing ventilator-associated pneumonia including bronchoalveolar lavage, protected specimen brush and non-directed bronchoalveolar lavage. There is a paucity of evidence regarding the safety profile of these techniques, particularly non-directed bronchoalveolar lavage. This service evaluation aimed to establish whether non-directed bronchoalveolar lavage is a safe procedure. A prospective service evaluation of non-directed bronchoalveolar lavage on our adult intensive care unit was undertaken by a senior physiotherapist trained into carrying out the procedure, measuring pre- and post-procedure vital signs including heart rate (HR), tidal volume (VT), systolic blood pressure (SBP) and pulse oximetry (SpO2). Eighty-five episodes in 41 patients were included in the evaluation. There was a statistically significant difference between pre- and immediately post-procedure recordings for all vital signs measure. HR (min-1), means (SD) 87.1 (16.4), 91.5 (16.5), 87.5 (15.9), 87.7 (15.7) respectively pre, immediately, 5 min after and 30 min after procedure (P < 0.01). SBP mmHg, means (SD) 133.9 (26.1), 142.1 (25.6), 136.9 (25.3), 134.8 (23.4) pre, immediately, 5 min and 30 min after procedure (P < 0.01). VT mL, median (range) 0.523 (0.118–1.180), 0.512 (0.131–1.05), 0.519 (0.104–0.95), 0.534 (0.110–1.080) each pre, immediately, 5 min and 30 min post procedure (P < 0.05). SpO2 %, median (range) 98 (89–100), 100 (96–100), 98 (92–100), 97 (90–100) again each pre-, immediately post, 5 and 30 min post-procedure time-points (P < 0.0001). The statistically significant difference was not detected between pre-, 5 or 30 min post-procedure time-points. None of the changes observed were clinically significant and no untoward events happened to any of the subjects included. Non-directed bronchoalveolar lavage is a safe and inexpensive procedure that can be carried out easily in an intensive care setting by a trained physiotherapist, avoiding the need for invasive bronchoscopy.",
keywords = "mini-lavage, Non-directed bronchial lavage, ventilator-associated pneumonia",
author = "Bonvento, {B. V.} and Rooney, {J. A.} and Columb, {M. O.} and McGrath, {B. A.} and Bentley, {A. M.} and Felton, {T. W.}",
year = "2018",
month = nov,
day = "13",
doi = "10.1177/1751143718811113",
language = "English",
journal = "Journal of the Intensive Care Society",
issn = "1751-1437",
publisher = "Sage Publications Ltd",

}

RIS

TY - JOUR

T1 - Non-directed bronchial lavage is a safe method for sampling the respiratory tract in critically ill patient

AU - Bonvento, B. V.

AU - Rooney, J. A.

AU - Columb, M. O.

AU - McGrath, B. A.

AU - Bentley, A. M.

AU - Felton, T. W.

PY - 2018/11/13

Y1 - 2018/11/13

N2 - Ventilated patients are at risk of acquiring ventilator-associated pneumonia. Various techniques are available for diagnosing ventilator-associated pneumonia including bronchoalveolar lavage, protected specimen brush and non-directed bronchoalveolar lavage. There is a paucity of evidence regarding the safety profile of these techniques, particularly non-directed bronchoalveolar lavage. This service evaluation aimed to establish whether non-directed bronchoalveolar lavage is a safe procedure. A prospective service evaluation of non-directed bronchoalveolar lavage on our adult intensive care unit was undertaken by a senior physiotherapist trained into carrying out the procedure, measuring pre- and post-procedure vital signs including heart rate (HR), tidal volume (VT), systolic blood pressure (SBP) and pulse oximetry (SpO2). Eighty-five episodes in 41 patients were included in the evaluation. There was a statistically significant difference between pre- and immediately post-procedure recordings for all vital signs measure. HR (min-1), means (SD) 87.1 (16.4), 91.5 (16.5), 87.5 (15.9), 87.7 (15.7) respectively pre, immediately, 5 min after and 30 min after procedure (P < 0.01). SBP mmHg, means (SD) 133.9 (26.1), 142.1 (25.6), 136.9 (25.3), 134.8 (23.4) pre, immediately, 5 min and 30 min after procedure (P < 0.01). VT mL, median (range) 0.523 (0.118–1.180), 0.512 (0.131–1.05), 0.519 (0.104–0.95), 0.534 (0.110–1.080) each pre, immediately, 5 min and 30 min post procedure (P < 0.05). SpO2 %, median (range) 98 (89–100), 100 (96–100), 98 (92–100), 97 (90–100) again each pre-, immediately post, 5 and 30 min post-procedure time-points (P < 0.0001). The statistically significant difference was not detected between pre-, 5 or 30 min post-procedure time-points. None of the changes observed were clinically significant and no untoward events happened to any of the subjects included. Non-directed bronchoalveolar lavage is a safe and inexpensive procedure that can be carried out easily in an intensive care setting by a trained physiotherapist, avoiding the need for invasive bronchoscopy.

AB - Ventilated patients are at risk of acquiring ventilator-associated pneumonia. Various techniques are available for diagnosing ventilator-associated pneumonia including bronchoalveolar lavage, protected specimen brush and non-directed bronchoalveolar lavage. There is a paucity of evidence regarding the safety profile of these techniques, particularly non-directed bronchoalveolar lavage. This service evaluation aimed to establish whether non-directed bronchoalveolar lavage is a safe procedure. A prospective service evaluation of non-directed bronchoalveolar lavage on our adult intensive care unit was undertaken by a senior physiotherapist trained into carrying out the procedure, measuring pre- and post-procedure vital signs including heart rate (HR), tidal volume (VT), systolic blood pressure (SBP) and pulse oximetry (SpO2). Eighty-five episodes in 41 patients were included in the evaluation. There was a statistically significant difference between pre- and immediately post-procedure recordings for all vital signs measure. HR (min-1), means (SD) 87.1 (16.4), 91.5 (16.5), 87.5 (15.9), 87.7 (15.7) respectively pre, immediately, 5 min after and 30 min after procedure (P < 0.01). SBP mmHg, means (SD) 133.9 (26.1), 142.1 (25.6), 136.9 (25.3), 134.8 (23.4) pre, immediately, 5 min and 30 min after procedure (P < 0.01). VT mL, median (range) 0.523 (0.118–1.180), 0.512 (0.131–1.05), 0.519 (0.104–0.95), 0.534 (0.110–1.080) each pre, immediately, 5 min and 30 min post procedure (P < 0.05). SpO2 %, median (range) 98 (89–100), 100 (96–100), 98 (92–100), 97 (90–100) again each pre-, immediately post, 5 and 30 min post-procedure time-points (P < 0.0001). The statistically significant difference was not detected between pre-, 5 or 30 min post-procedure time-points. None of the changes observed were clinically significant and no untoward events happened to any of the subjects included. Non-directed bronchoalveolar lavage is a safe and inexpensive procedure that can be carried out easily in an intensive care setting by a trained physiotherapist, avoiding the need for invasive bronchoscopy.

KW - mini-lavage

KW - Non-directed bronchial lavage

KW - ventilator-associated pneumonia

U2 - 10.1177/1751143718811113

DO - 10.1177/1751143718811113

M3 - Article

AN - SCOPUS:85058944839

JO - Journal of the Intensive Care Society

JF - Journal of the Intensive Care Society

SN - 1751-1437

ER -