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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El diagn&#243;stico de la neumon&#237;a nosocomial es especialmente dif&#237;cil en pacientes intubados debido a la escasa especificidad de sus caracter&#237;sticas clinicorradiol&#243;gicas&#46; El objetivo de este trabajo ha sido evaluar la utilidad diagn&#243;stica de las fibras de elastina &#40;FE&#41; en el broncoaspirado &#40;BAS&#41; como marcador de neumon&#237;a en pacientes ventilados&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se han estudiado prospectivamente 47 pacientes bajo ventilaci&#243;n mec&#225;nica &#40;VM&#41; con sospecha de neumon&#237;a nosocomial&#46; A todos ellos se les practic&#243; fibrobroncoscopia &#40;FB&#41; con toma de muestras mediante cat&#233;ter telescopado &#40;CT&#41; y lavado broncoalveolar &#40;LBA&#41;&#46; Adem&#225;s&#44; se examin&#243; una porci&#243;n purulenta del BAS&#44; tras a&#241;adir KOH al 40&#37;&#44; para determinar la presencia de FE&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se observaron FE en 15 casos&#44; de las cuales 11 eran neumon&#237;as&#44; siendo 3 de los 4 casos restantes portadores de patolog&#237;a susceptible de producir necrosis pulmonar &#40;sensibilidad del 52&#37; y especificidad del 85&#37;&#41;&#46; Diez de los 17 microorganismos aislados en los casos de neumon&#237;a con FE positivas fueron gramnegativos&#44; aunque el germen m&#225;s frecuentemente encontrado fue S&#46; aureus&#46; No hubo diferencias en el pron&#243;stico entre los pacientes con neumon&#237;a y FE positivas respecto a los que ten&#237;an las FE negativas&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En conclusi&#243;n&#44; una vez descartadas otras neumopat&#237;as necrosantes&#44; la presencia de FE en el BAS puede ofrecer un apoyo razonable en el diagn&#243;stico de algunos pacientes con neumon&#237;a asociada al ventilador&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The diagnosis of nosocomial pneumonia is especially difficult in intubated patients due to the low specificity of their clinico-radiological signs&#46; The objective of this study was to evaluate the usefulness of basing diagnosis on elastin fibers &#40;EF&#41; in bronchoaspirate &#40;BAS&#41; as an indication of pneumonia in mechanically-ventilated &#40;MV&#41; patients&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Forty-seven MV patients suspected of having nosocomial pneumonia were studied prospectively&#46; Fibrobroncoscopy was carried out on all patients and samples were obtained using a protected catheter brush &#40;PCB&#41; and bronchoalveolar lavage &#40;BAL&#41;&#46; A purulent sample of BAS was also examined&#44; after addition of 40&#37; KOH&#44; to determine the presence of EF&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">EF was found in 15 patients&#44; 11 of whom had pneumonia while 3 more had necrotizing pneumonia &#40;sensitivity 52&#37;&#44; specificity 85&#37;&#41;&#46; Ten of the 17 microorganisms isolated in the cases of EF positive pneumon&#237;a were gram negative&#44; although the germ found most often was S&#46; aureus&#46; There were no differences in the prognosis for pneumonia patients who were EF positive and those who were EF negative&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In conclusion&#44; once necrotizing pneumopathology has been ruled out&#44; the presence of EF in BAS may offer reasonable support for firm diagnosis in some MV patients with pneumonia&#46;</p></span>"
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Vol. 30. Issue 4.
Pages 188-191 (April 1994)
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Vol. 30. Issue 4.
Pages 188-191 (April 1994)
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Utilidad de las fibras de elastina como marcador diagnóstico de la neumonía asociada al ventilador
Usefulness of elastin fibers as a diagnostic sign in mechanically-ventilated patients
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F. Rodríguez de Castro1, O. Acosta Fernández, J.A. Caminero Luna, P. Cabrera Navarro
Sección de Neumología. Universidad de Las Palmas de Gran Canaria
J. Solé Violán*, A. Rey López**, J.C. Martín González*
* Servicio de Medicina Intensiva. Hospital Universitario Nuestra Señora del Pino. Facultad de Ciencias Médicas y de la Salud
** Servicío de Anatomía Patológica. Hospital Universitario Nuestra Señora del Pino. Facultad de Ciencias Médicas y de la Salud
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El diagnóstico de la neumonía nosocomial es especialmente difícil en pacientes intubados debido a la escasa especificidad de sus características clinicorradiológicas. El objetivo de este trabajo ha sido evaluar la utilidad diagnóstica de las fibras de elastina (FE) en el broncoaspirado (BAS) como marcador de neumonía en pacientes ventilados.

Se han estudiado prospectivamente 47 pacientes bajo ventilación mecánica (VM) con sospecha de neumonía nosocomial. A todos ellos se les practicó fibrobroncoscopia (FB) con toma de muestras mediante catéter telescopado (CT) y lavado broncoalveolar (LBA). Además, se examinó una porción purulenta del BAS, tras añadir KOH al 40%, para determinar la presencia de FE.

Se observaron FE en 15 casos, de las cuales 11 eran neumonías, siendo 3 de los 4 casos restantes portadores de patología susceptible de producir necrosis pulmonar (sensibilidad del 52% y especificidad del 85%). Diez de los 17 microorganismos aislados en los casos de neumonía con FE positivas fueron gramnegativos, aunque el germen más frecuentemente encontrado fue S. aureus. No hubo diferencias en el pronóstico entre los pacientes con neumonía y FE positivas respecto a los que tenían las FE negativas.

En conclusión, una vez descartadas otras neumopatías necrosantes, la presencia de FE en el BAS puede ofrecer un apoyo razonable en el diagnóstico de algunos pacientes con neumonía asociada al ventilador.

The diagnosis of nosocomial pneumonia is especially difficult in intubated patients due to the low specificity of their clinico-radiological signs. The objective of this study was to evaluate the usefulness of basing diagnosis on elastin fibers (EF) in bronchoaspirate (BAS) as an indication of pneumonia in mechanically-ventilated (MV) patients.

Forty-seven MV patients suspected of having nosocomial pneumonia were studied prospectively. Fibrobroncoscopy was carried out on all patients and samples were obtained using a protected catheter brush (PCB) and bronchoalveolar lavage (BAL). A purulent sample of BAS was also examined, after addition of 40% KOH, to determine the presence of EF.

EF was found in 15 patients, 11 of whom had pneumonia while 3 more had necrotizing pneumonia (sensitivity 52%, specificity 85%). Ten of the 17 microorganisms isolated in the cases of EF positive pneumonía were gram negative, although the germ found most often was S. aureus. There were no differences in the prognosis for pneumonia patients who were EF positive and those who were EF negative.

In conclusion, once necrotizing pneumopathology has been ruled out, the presence of EF in BAS may offer reasonable support for firm diagnosis in some MV patients with pneumonia.

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Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
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