Resultados preliminares y factibilidad del mini lavado bronco-alveolar en pacientes cursando falla respiratoria severa
Revista médica de Chile (Impresa)
To recognize the etiological agent responsible for severe acute respiratory failure (ARF) in patients in mechanical ventilation (MV) is important to determine their treatment and prognosis, and to avoid the excessive use of antibiotics. Mini bronchoalveolar lavage (mini BAL) is a blind, non bronschoscopic procedure, used to obtain samples from the lower respiratory tract from patients on mechanical ventilation (MV). Aim: To assess the feasibility, complications and preliminary results of mini
... y results of mini BAL among patients with severe ARF on MV. Material and Methods: Prospective study in 17 patients with acute lung injury (ALI ) or acute respiratory distess syndrome (ARDS) on MV and with negative conventional microbiological studies. Mini BAL was performed using standardized protocols. Hemodynamic and respiratory parameters where measured before and after the procedure. Samples obtained were sent to quantitative cultures. Results: At baseline: APACHE II score of 22 ± 6,7, P a O 2 /F i O 2 ratio was 176.6 ± 48.6 and the oxygenation index was 9.74 ± 3.78. All procedures were performed by an ICU resident. Thirty fi ve percent of the procedures had positive cultures and no complications related to the procedures were reported. The procedure lasted an average of 12 minutes and the instilled and rescued volume were 60 ml and 19.6 ml, respectively. There were no signifi cant differences between hemodynamic and respiratory variables before and after the procedure. Conclusions: Mini BAL is a safe, fast and easy technique for obtaining samples from the inferior airway in patients with ALI or ARDS on MV. (Rev Med Chile 2011; 139: 1292-1297.