Comparison of Blind Endotracheal Aspiration and Bronchoscopic Brush Biopsy Sampling Methods for Bacteriological Diagnosis of Ventilator-Associated Pneumonia in Intensive Care Unit.

Abstract

Background:The diagnosis of ventilator-associated pneumonia (VAP) is a challenge because the clinical signs and symptoms lack both sensitivity and specificity. Further confirmation of the diagnosis of VAP can be done by other diagnostic procedures such as bronchoscopic and blind endotracheal aspiration, but the selection of either diagnostic procedure is debatable.Aims:The aim is to study and compare the role of bronchoscopic protected specimen brush biopsy (PSBB) and blind endotracheal aspiration for diagnosis of VAP.Settings and Design:This prospective comparative study was conducted in multidisciplinary Intensive Care Unit of a tertiary care hospital.Materials and Methods:Thirty patients clinically diagnosed to have VAP were further evaluated by bronchoscopic and blind endotracheal aspiration. The P value of PSBB and blind aspiration techniques was calculated, taking clinical pulmonary infection score of ≥6 as reference standard.Statistical Analysis Used:Statistical analysis was done using Chi-square and t-test.Results and Conclusions:Our study shows that for the diagnosis of VAP, PSBB and blind aspiration had Chi-square value of 0.83 with degree of freedom 1 which showed P = 0.3623 which is not significant. t-test value is 0.402 with degree of freedom 1 and P = 0.7567 which is still not significant. There was a good microbiologic concordance among bronchoscopic and nonbronchoscopic distal airway sampling techniques. Blind endotracheal aspiration is a comparable technique for bacteriological diagnosis of VAP.