Validation of the usage of tracheal aspiration considering children with lung disease

Abstract

Listen

Translate article

Validation of the usage of tracheal aspiration considering children with lung disease This study investigates the usability of nasal tracheal aspiration (NTA) by comparing NTA against bronchoalveolar lavage (BAL) Methods: 173 paired samples of NTA and BAL were performed on 164 paediatric patients. The samples were collected on patients with spontaneous breathing during general anaesthesia. This study retrospectively compares the microbiological cultures obtained by the NTA and BAL Results: Concerning complete bacteria concordance the overall similarity is 49%, sensitivity 35%, specificity 66%, positive predictive value 25% and negative predictive value is 65%. When focusing on +/- growth of pathogen bacteria the similarity is 70%, sensitivity 74%, specificity 66%, positive predictive value 74% and negative predictive value 65%. Patients with cystic fibrosis have statistic significant better parameters than the overall samples regarding similarity 88%, sensitivity 92% and positive predictive value of 92% for +/- growth. If the common throat bacteria H.influenzae and Moraxella are the only difference between NTA and BAL concerning the bacteria concordance the omission of these improves the statistic significant specificity of 91%. Antibiotic treatment at the time of the examinations seems to have a positive tendency towards improved sensitivity, however not statistical significant Conclusion: The study indicates that NTA is clinically useful to evaluate if the lower airways are colonized or not, but generally not concerning which specific bacteria. The clinically usage of NTA remains important as both positive and negative findings are of great value concerning children with chronic lung diseases