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Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated newborns
Author(s) -
Rigal E.,
Roze J. C.,
Villers D.,
Derriennic M.,
DavidMelon V.,
LacroixMechinaud F.,
Mouzard A.
Publication year - 1990
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950080411
Subject(s) - medicine , predictive value , respiratory tract , brush , respiratory tract infections , prospective cohort study , surgery , respiratory system , anesthesia , electrical engineering , engineering
The precise diagnosis of lower respiratory tract infection in the critically ill newborn remains a difficult challenge. The bronchoscopic protected specimen brush (PSB) is a reliable method in intubated adults. Because the bronchoscopic procedure is not generally available for young children, Zucker proposed a blind technique for introducing the PSB into the distal airways. His results were promising but were not compared with any bacteriologic reference method. Therefore, we wanted to evaluate this technique in comparison with the open lung biopsy (OLB) when it could be ethically accomplished. Eleven PSB were collected simultaneously with an OLB. The sensitivity of the PSB procedure was 100%, its specificity 88%, its positive predictive value 66%, and its negative predictive value 100%. There were no complications secondary to the PSB procedure. In this short study, the PSB procedure using a blind technique is safe and feasible to obtain uncontaminated specimens in intubated and ventilated newborns, and is largely accurate in identifying the bacterial etiologic agent of lower respiratory tract infection. Pediatr Pulmonol 1990; 8:268‐272.