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Safety profile of blind bronchial sampling—A prospective study in pediatric intensive care unit
Author(s) -
Gupta Neeraj,
Sachdev Anil,
Gupta Dhiren,
Gupta Suresh
Publication year - 2018
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.23989
Subject(s) - medicine , anesthesia , pediatric intensive care unit , prospective cohort study , intensive care unit , blood sampling , hemodynamics , mechanical ventilation , ventilation (architecture) , ventilator associated pneumonia , pneumonia , oxygenation , intubation , intensive care , surgery , intensive care medicine , mechanical engineering , engineering
Objective To study the safety profile of blind bronchial sampling in mechanically ventilated children. Design Prospective interventional study. Setting Tertiary level pediatric intensive care unit of a multispecialty hospital. Patients Children aged 1 month to 16 years on mechanical ventilator for ≥48 h, were assessed by clinical pulmonary infection score for ventilator‐associated pneumonia (VAP). Interventions Blind bronchial sampling was performed following standard procedural guidelines. The hemodynamic, ventilation parameters, and arterial blood gases done before, and in next 24 h post procedure were recorded and compared. Measurements and Main Results Among the 40 enrolled children, VAP was suspected at 5.8 ± 3.7 days post intubation with insignificant increase in median (IQR) PELOD score to 15 (11‐23) from 13.5 (11‐23) ( P value 0.29). A statistically significant increase in mean blood pressure (75.5 ± 14.7 to 79.1 ± 14.2, P 0.04) and transient drop in SpO 2 (98.2 ± 2.3 to 92.2 ± 9.2, P < 0.001) were noted with insignificant change in heart rate (128.7 ± 25.6 vs 132.0 ± 30.8, P 0.52), though these variations were clinically not significant. There were no major complications like significant airway bleed, arrhythmia, air leaks, edema, and change in pulmonary infiltrates during the procedure. There were no significant (either clinical or statistical) effects of BBS procedure, whether transient or prolonged, on ventilatory requirements or gas exchange parameters. Conclusions Blind bronchial sampling is a safe procedure in children with no major adverse events related to hemodynamics, oxygenation, and ventilation parameters.