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- W2041551118 abstract "We tested the effectiveness of protected bronchoalveolar lavage (PBAL), performed through a protected transbronchoscopic balloon-tipped (PBT) catheter, in collecting distal airway secretions with a minimal degree of contamination. The PBAL had ⩽ 1% squamous epithelial cells in 91% of specimens and an absence of bacterial growth in 59% of patients without pneumonia. Using a threshold of 104 cfu/ml we had one false positive result in 33 patients without pneumonia and one false negative in 13 patients with pneumonia. Quantitative bacterial cultures of the PBAL specimens had a diagnostic sensitivity of 97% and a specificity of 92%, with a positive predictive value of 97% and a negative predictive value of 92%. The diagnostic efficiency was 96%. The presence of intracellular organisms in ⩾ 2% of the recovered alveolar cells (Giemsa stain) was seen in all but two patients with pneumonia (on corticosteroids) and in none of the patients without pneumonia. Gram stains of the PBAL specimens were positive in all but one patient with pneumonia and negative in all but one patient without infection (patient with endobronchial narrowing secondary to neoplasm with false positive cultures). Either the Giemsa or the Gram stain was positive in all patients with pneumonia, allowing early and accurate diagnosis of lower respiratory tract infection before the results of cultures were available. The time off antibiotic therapy before bronchoscopy did not affect the result of PBAL cultures, contrary to what we observed for the protected brush specimen." @default.
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- W2041551118 date "1991-04-01" @default.
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- W2041551118 title "Protected Bronchoalveolar Lavage: A New Bronchoscopic Technique to Retrieve Uncontaminated Distal Airway Secretions" @default.
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- W2041551118 doi "https://doi.org/10.1164/ajrccm/143.4_pt_1.855" @default.
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