Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping catheter

Intensive Care Med. 1993;19(7):377-82. doi: 10.1007/BF01724876.


Objectives: To demonstrate that blind insertion of the protected telescoping catheter (PTC-NB) through the orotracheal tube can provide reliable pulmonary samples for the diagnosis of nosocomial pneumonia (NP) in ventilated patients.

Design: We performed a random comparison between the protected telescoping catheter introduced through a bronchofiberscope (PTC-B) and the PTC-NB to diagnose NP.

Setting: A general intensive care unit of a University Hospital.

Patients: 40 consecutive patients on mechanical ventilation and with suspicion of NP. The diagnosis of NP was suspected by clinical and chest X-ray findings.

Measurements and results: NP was confirmed microbiologically in 26 (65%) patients and maintained in 8 patients by clinical and radiological criteria. PTC-NB confirmed the microbiological diagnosis of PN in 21 (80%) patients. The use of antibiotics prior taking respiratory samples reduced the sensitivity of PTC-NB and PTC-B from 100-74% and from 94-70% (p = 0.001). Both techniques agreed in 24 of 33 (73%) patients but such agreement was better when PN was on the right lung. Two patients developed a self-limiting hemoptysis after the PTC-B procedure.

Conclusions: PTC-NB is as sensitive as specific as PTC-B for diagnosing PN in mechanically ventilated patients, being a much easier technique to use.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bronchoalveolar Lavage Fluid / microbiology
  • Bronchoscopy / methods
  • Cross Infection / diagnosis*
  • Cross Infection / etiology*
  • Cross Infection / microbiology
  • Female
  • Fiber Optic Technology
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pneumonia / diagnosis*
  • Pneumonia / etiology*
  • Pneumonia / microbiology
  • Prospective Studies
  • Pseudomonas aeruginosa / isolation & purification
  • Random Allocation
  • Respiration, Artificial / adverse effects*
  • Staphylococcus aureus / isolation & purification