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Vol. 37. Issue 8.
Pages 325-334 (August 2001)
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Vol. 37. Issue 8.
Pages 325-334 (August 2001)
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Recomendaciones para el diagnóstico de la neumonía asociada a ventilación mecánica
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F. Álvarez Lerma, A. Torres Martí
Corresponding author
atorres@medicina.ub.es

Correspondencia: UVIR. Servicio de Neumología. Instituto Clínic de Neumología y Cirugía Torácica. Hospital Clínic. 08036 Barcelona
, F. Rodríguez de Castro
y Comisión de Expertos del Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (GTEI-SEMICYUC), Área de Trabajo de Tuberculosis e Infecciones Respiratorias (TIR) de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) y Grupo de Estudio de Infección Hospitalaria de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEIH-SEIMC)
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Bibliografía
[1.]
American Thoracic Society.
Hospital-acquired pneumonia in adults: diagnosis, assessment of severity, initial antimicrobial therapy, and preventative strategies. A consensus statement.
Am J Respir Crit Care Med, 153 (1996), pp. 1711-1725
[2.]
S.K. Pingleton, J.Y. Fagon, K.V. Leeper.
Patient selection for clinical investigation of ventilator-associated pneumonia. Criteria for evaluating diagnostic techniques.
Chest, 102 (1992), pp. 553S-556S
[3.]
M. Palomar, F. Álvarez-Lerma, M.A. De la Cal, J. Insausti.
Olaechea P y Grupo de Estudio de Vigilancia de Infección Nosocomial en UCI (ENVIN-UCI).
Time of onset of ventilator associated pneumonia (VAP): implications for antibiotic therapy. ICAAC, Toronto, (septiembre de 2000),
[4.]
A. Torres, M.R. De Celis, S. Bello, J. Blanquer, J. Dorca, L. Molinos, et al.
Diagnóstico y tratamiento de la neumonía nosocomial.
Arch Bronconeumol, 33 (1997), pp. 346-350
[5.]
F. Álvarez Lerma, B. Álvarez-Sánchez, F. Barcenilla.
Protocolo diagnóstico y terapéutico de la neumonía asociada a ventilación mecánica.
Guía de práctica clínica en medicina intensiva. Sociedad Española de Medicina Intensiva y Unidades Coronarias, pp. 1-8
[6.]
R.F. Grossman, A. Fein.
Evidence-based assessment of diagnostic tests for ventilator-associated pneumonia.
Chest, 117 (2000), pp. 177-181
[7.]
J.Y. Fagon, J. Chastre, A.J. Hance, Y. Domart, J.L. Trouillet, C. Gilbert.
Evaluation of clinical judgment in the identification and treatment of nosocomial pneumonia in ventilated patients.
Chest, 103 (1993), pp. 547-553
[8.]
K. Sutherland, K. Steinberg, R. Maunder, J.A. Milberg, D. Allen, L. Hindson.
Pulmonary infection during the acute respiratory distress syndrome.
Am J Respir Crit Care Med, 152 (1995), pp. 550-556
[9.]
L. Papazian, P. Thomas, L. Garbe, I. Guignon, X. Thirion, J. Charrel, et al.
Bronchoscopic or blind sampling techniques for the diagnosis of ventilator-associated pneumonia.
Am J Respir Crit Care Med, 152 (1995), pp. 1982-1991
[10.]
J.F. Timsit, B. Misset, F. Goldstein, P. Vaury, J. Carlet.
Reappraisal of distal diagnostic testing in the diagnosis of ICU-acquired pneumonia.
Chest, 108 (1995), pp. 1632-1639
[11.]
R.C. Bell, J.J. Coalson, J.D. Smith, J.r. Johanson WG.
Multiple organ system failure and infection in adult respiratory distress syndrome.
Ann Intern Med, 99 (1983), pp. 293-298
[12.]
C.P. Andrews, J.J. Coalson, J.D. Smith.
Diagnosis of nosocomial bacterial pneumonia in acute, diffuse lung injury.
Chest, 80 (1981), pp. 254-258
[13.]
J.Y. Fagon, J. Chastre, A.J. Hance, J.L. Guiguet, J.L. Troillet, Y. Domart, et al.
Detection of nosocomial lung infection in ventilated patients: use of a protected specimen brush and quantitative culture techniques in 147 patients.
Am Rev Respi Dis, 138 (1988), pp. 110-116
[14.]
A. Torres, M. El-Ebiary, L. Padró, J. González, J. Puig de la Bellacasa, J. Ramírez, et al.
Validation of different techniques for the diagnosis of ventilator-associated pneumonia: comparison with immediate postmortem pulmonary biopsy.
Am J Respir Crit Care Med, 149 (1994), pp. 324-331
[15.]
J.S. Garner, W.R. Jarvis, T.G. Emori, T.C. Horan, J.M. Hughes.
CDC definitions for nosocomial infections.
Am J Infect Control, 16 (1988), pp. 128-140
[16.]
G.U. Meduri, G.L. Mauldin, R.G. Wunderink, K.V. Leeper, E. Tolley, G. Mayhall.
Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator-associated pneumonia.
Chest, 106 (1994), pp. 221-235
[17.]
J.J. Rouby, E.M. De Lassale, P. Poete, M.H. Nicolas, L. Bodin, V. Jarlier, et al.
Nosocomial bronchopneumonia in the critically ill: Histologic and bacteriologic aspects.
Am Rev Respir Dis, 146 (1992), pp. 1059-1066
[18.]
L. Beydon, M. Saada, N. Liu, J.P. Becquemin, A. Harf, F. Bonnet, et al.
Can portable chest x-ray examination accurately diagnose lung consolidation after major abdominal surgery?: a comparison with computed tomography scan.
Chest, 102 (1992), pp. 1698-1703
[19.]
R.G. Wunderink, L.S. Woldenberg, J. Zeiss, C.M. Day, J. Ciemins, D. Lacher.
The radiologic diagnosis of autopsy-proven ventilator-associated pneumonia.
Chest, 101 (1992), pp. 458-463
[20.]
N. Fabregas, S. Ewig, A. Torres, M. El-Ebairy, J. Ramírez, J. Puig de la Bellacasa, et al.
Clinical diagnosis of ventilator-associated pneumonia revisited: comparative evaluation using immediate postmorten biopsies.
Thorax, 54 (1999), pp. 867-873
[21.]
H.T. Winer-Muram, S. Rubin, J. Ellis, S.G. Jennings, K.L. Arheart, R.G. Wunderink, et al.
Pneumonia and ARDS in patients receiving mechanical ventilation. Diagnostic accuracy of chest radiography.
Radiology, 188 (1993), pp. 479-485
[22.]
M.S. Lefcoe, G.A. Fox, D.J. Leasa, R.K. Sparrow, D.G. McCormack.
Accuracy of portable chest radiography in the critical care setting: diagnosis of pneumonia based on quantitative cultures obtained from protected brush catheter.
Chest, 105 (1994), pp. 885-887
[23.]
M. El-Ebiary, A. Torres, J. González, J. Puig de la Bellacasa, M. García, M.T. Jiménez de Anta, et al.
Quantitative cultures of endotracheal aspirates for the diagnosis of ventilator-associated pneumonia.
Am Rev Respir Dis, 148 (1993), pp. 1552-1557
[24.]
A. Sauaia, F. Moore, E. Moore, J.B. Haenel, L. Kaneer, R.A. Read.
Diagnosing pneumonia in mechanically ventilated trauma patients: endotracheal aspirate versus bronchoalveolar lavage.
J Trauma, 35 (1993), pp. 512-517
[25.]
C.H. Marquette, M.C. Copin, F. Wallet, R. Nevierte, F. Saulnier, D. Mathieu, et al.
Diagnostic tests for pneumonia in ventilated patients: prospective evaluation of diagnostic accuracy using histology as a diagnostic gold standard.
Am J Respir Crit Care Med, 151 (1995), pp. 1878-1888
[26.]
A. Torres, A. Martos, J. Puig de la Bellacasa, M. Ferrer, M. El-Ebairy, J. González, et al.
Specificity of endotracheal aspiration, protected specimen brush, and bronchoalveolar lavage in mechanically ventilated patients.
Am Rev Respir Dis, 147 (1993), pp. 952-957
[27.]
C. Marquette, F. Herengt, D. Mathieu, F. Saulnier, R. Courcol, P. Ramon.
Diagnosis of pneumonia in mechanically ventilated patients: repeatability of the protected specimen brush.
Am Rev Respir Dis, 147 (1993), pp. 211-214
[28.]
B. Jourdain, A. Novara, M. Joly-Guillou, M.C. Dombret, S. Calvat, J.L. Trouillet, et al.
Role of quantitative cultures of endotracheal aspiratesin the role of nosocomial pneumonia.
Am J Respir Crit Care Med, 152 (1995), pp. 241-246
[29.]
J.Y. Fagon, J. Chastre, M. Wolff, C. Gervais, S. Parer-Aubas, F. Stéphan, et al.
Invasive and noninvasive strategies for management os suspected ventilator-associated pneumonia. A randomized trial.
Ann Intern Med, 132 (2000), pp. 621-630
[30.]
M. Ruiz, A. Torres, S. Ewig, M.A. Marcos, A. Alcón, R. Lledó, et al.
Noninvasive versus invasive microbial investigation in ventilatorassociated pneumonia. Evaluation of outcome.
Am J Respir Crit Care Med, 162 (2000), pp. 119-125
[31.]
R. Lambert, L. Vereen, R. George.
Comparison of tracheal aspirates and protected brush catheter specimens for identifying pathogenic bacteria in mechanically ventilated patients.
Am J Med Sci, 297 (1989), pp. 377-382
[32.]
J.Y. Chastre, J.Y. Fagon, P. Soler, M. Bornet, Y. Domart, J.L. Trouillet, et al.
Diagnosis of nosocomial bacterial pneumonia in intubated patients undergoing ventilation: comparison of the usefulness of bronchoalveolar lavage and the protected specimen brush.
Am J Med, 85 (1988), pp. 499-506
[33.]
R. Baughman, J. Thorpe, J. Staneck, M. Rashkin, P. Frame.
Use of the protected brush in patients with endotracheal or tracheostomy tubes.
Chest, 91 (1987), pp. 233-236
[34.]
J.Y. Chastre, F. Viau, P. Brun, J. Pierre, M.C. Dauge, A. Bouchama, et al.
Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patient.
Am Rev Respir Dis, 130 (1984), pp. 924-929
[35.]
A. Torres, J. Puig de la Bellacasa, R. Rodríguez Roisín, M.T. Jiménez de Anta, A. Agustí-Vidal.
Diagnostic value of telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia using the Metras catheter.
Am Rev Respir Dis, 138 (1988), pp. 117-120
[36.]
G.U. Meduri, J.Y. Chastre.
The standardization of bronchoscopic techniques for ventilator-associated pneumonia.
Chest, 102 (1992), pp. 557S-564S
[37.]
C.H.H. Marquette, F. Georges, F. Wallett, F. Ramon, R. Saulnier, D. Neviere, et al.
Diagnostic efficiency of endotracheal aspirates with quantitative bacterial cultures in intubated patients with suspected pneumonia.
Am Rev Respir Dis, 148 (1993), pp. 138-144
[38.]
J. Solé-Violán, F. Rodríguez de Castro, A. Rey, J.C. Martín-González, P. Cabrera-navarro.
Usefulness of microscopic examination of intracellular organisms in lavage fluid in ventilator-associated pneumonia.
Chest, 106 (1994), pp. 889-894
[39.]
J.F. Timsit, B. Misset, S. Francoual, F.W. Golstein, P. Vaury, J. Carlet.
Is protected specimen brush a reproducible method to diagnose ICU-acquired pneumonia?.
Chest, 104 (1993), pp. 104-108
[40.]
J. Solé-Violán, F. Rodríguez de Castro, J. Caminero-Luna, A. Bortes- Benítez, J.L. Manzano-Alonso.
Comparative efficacy of bronchoalveolar lavage and telescoping plugged catheter in the diagnosis of pneumonia in mechanically ventilated patients.
Chest, 103 (1993), pp. 386-390
[41.]
C. Richard, M. Pezzano, B. Bouhaja, E. Rottman, A. Rimailho, B. Rion, et al.
Comparison of non-protected lower respiratory tract secretions and protected specimen brush samples in the diagnosis of pneumonia.
Intensive Care Med, 14 (1988), pp. 30-33
[42.]
F. Rodríguez de Castro, J. Solé-Violán, B. Lafarga, J. Caminero, J.L. Manzano.
Reliability of the bronchoscopic protected catéter brush in the diagnosis of pneumonia in mechanically ventilated patients.
Crit Care Med, 19 (1991), pp. 171-175
[43.]
A. Torres, J. Puig de la Bellacasa, A. Xaubet, J. González, R. Rodríguez- Roisín, M.T. Jiménez de Anta, et al.
Diagnostic value of quantitative cultures of bronchoalveolar lavage and telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia.
Am Rev Respir Dis, 140 (1989), pp. 306-310
[44.]
J. Solé-Violán, F. Rodríguez de Castro, A. Rey, J. Freixinet, A. Aranda, J. Caminero, et al.
Comparison of bronchoscopic diagnostic techniques with histological findings in brain dead organ donors without suspected pneumonia.
Thorax, 51 (1996), pp. 929-931
[45.]
J. Valles, J. Rello, R. Fernández, L. Blanch, F. Baigorri, J. Mestre, et al.
Role of bronchoalveolar lavage in mechanically ventilated patients with suspected pneumonia.
Eur J Clin Microbiol Infect Dis, 13 (1994), pp. 549-558
[46.]
J. Timsit, B. Misset, B. Renaud, F. Goldstein, J. Carlet.
Effect of previous antimicrobial therapy on the accuracy of the main procedures used to diagnose nosocomial pneumonia in patients who are using ventilation.
Chest, 108 (1995), pp. 1036-1040
[47.]
J. Pugin, R. Auckenthaler, N. Mili, J.P. Janssesns, P.D. Lew, P.M. Futer.
Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic “blind” bronchoalveolar lavage fluid.
Am Rev Respir Dis, 143 (1991), pp. 1121-1129
[48.]
C.M. Luna, P. Vujavich, M.S. Niederman, C. Vay, C. Gherardi, J. Matera, et al.
Impact of bronchoalveolar lavage data on the therapy and outcome of ventilator associated pneumonia.
Chest, 111 (1997), pp. 767-785
[49.]
F. Rodríguez de Castro, J. Solé, R. Elcuaz.
Quantitative cultures of protected brush specimens and bronchoalveolar lavage in ventilated patients without suspected pneumonia.
Am J Respir Crit Care Med, 149 (1994), pp. 320-323
[50.]
R. Middleton, W. Broughton, M. Kirkpatrick.
Comparison of four methods for assessing airway bacteriology in intubated mechanically ventilated patients.
Am J Med Sci, 304 (1992), pp. 239-245
[51.]
G.U. Meduri, R.G. Wunderink, K.V. Leeper, D.H. Beals.
Management of bacterial pneumonia in ventilated patients. Protected bronchoalveolar lavage as a diagnostic tool.
Chest, 101 (1992), pp. 500-508
[52.]
G.U. Meduri, D.H. Beals, A.G. Maijub, V. Baselski.
Protected bronchoalveolar lavage. A new bronchoscopic technique to retrieve uncontaminated distal airway secretions.
Am Rev Respir Dis, 143 (1991), pp. 855-864
[53.]
A. Torres, M. El-Ebiary, N. Fabregas, J. González, J. Puig de la Bellacasa, C. Hernández, et al.
Value of intracellular bacteria detection in the diagnosis of ventilator-associated pneumonia.
Thorax, 51 (1996), pp. 378-384
[54.]
J. Chastre, J. Fagon, M. Bornet-Lecso, S. Calvat, M.C. Drombret, R. al Khani, et al.
Evaluation of bronchoscopic techniques for the diagnosis of nosocomial pneumonia.
Am J Respir Crit Care Med, 152 (1995), pp. 231-240
[55.]
L. Guerra, R. Baughman.
Use of bronchoalveolar lavage to diagnose bacterial pneumonia in mechanically ventilated patients.
Crit Care Med, 18 (1990), pp. 169-173
[56.]
B. Barreiro, J. Dorca, F. Manresa, I. Catalá, L. Esteban, R. Verdaguer, et al.
Protected bronchoalveolar lavage in the diagnosis of ventilator-associated pneumonia.
Eur Respir J, 9 (1996), pp. 1500-1507
[57.]
S. Aubas, P. Aubas, X. Capdevila, H. Darbas, J.P. Roustan, J. Du Cailar.
Bronchoalveolar lavage for diagnosing bacterial pneumonia in mechanically ventilated patients.
Am J Respir Crit Care Med, 149 (1994), pp. 860-866
[58.]
L. Papazian, C. Martin, J. Albanese, P. Saux, J. Chanel, F. Gouin, et al.
Comparison of two methods of bacteriologic sampling of the lower respiratory tract: a study in ventilated patients with nosocomial bronchopneumonia.
Crit Care Med, 17 (1989), pp. 461-464
[59.]
L. Papazian, C. Martin, B. Meric, J.F. Duman, F. Gouin.
A reappraisal of blind bronchial sampling in the microbiologic diagnosis of nosocomial bronchopneumonia.
Chest, 103 (1993), pp. 236-242
[60.]
L.A. Pham, C. Brun-Buisson, P. Legrand, A. Rauss, F. Verra, L. Brochard, et al.
Diagnosis of nosocomial pneumonia in mechanically ventilated patiens. Comparisson of a plugged telescoping catheter with the protected specimen brush.
Am Rev Respir Dis, 143 (1991), pp. 1055-1061
[61.]
R. Jorda, F. Parras, J. Ibáñez, J. Reina, J. Bergadá, J.M. Raurich.
Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping catheter.
Intensive Care Med, 19 (1993), pp. 377-382
[62.]
J.J. Rouby, M.D. Rossignon, M.H. Nicolas, E.M. De Lassale, S. Cristin, J. Grosset, et al.
A propective study of protected bronchoalveolar lavage in the diagnosis of nosocomial pneumonia.
Anesthesiology, 71 (1989), pp. 179-185
[63.]
J.J. Rouby, E.M. De Lassale, P. Poette, M.H. Nicolas, L. Bodin, V. Jarlier, et al.
Nosocomial bronchopneumonia in the critically ill.
Am Rev Respir Dis, 146 (1992), pp. 1059-1066
[64.]
M. Kollef, K. Bock, R. Richards, M. Hearns.
The safety and diagnostic accuracy of minibronchoalveolar lavage in patients with suspected ventilator-associated pneumonia.
Ann Inter Med, 122 (1995), pp. 743-748
[65.]
P. Gaussorgues, D. Pierno, P. Bachman, F. Boyer, J.M. Gerard, P. Leger, et al.
Comparison of nonbronchoscopic bronchoalveolar lavage to open lung biopsy for bacteriological diagnosis of pulmonary infections in mechanically ventilated patients.
Intensive Care Med, 15 (1989), pp. 94-98
[66.]
C. A'Court, C. Garrard, D. Crook.
Microbiological lung surveillance in mechanically ventilated patients, using non-directed bronchial lavage and quantitative culture.
Q J Med, 86 (1993), pp. 635-648
[67.]
P. Marik.
A comparison of bronchoscopic vs blind protected speciman brush sampling in patients with siuspected ventilator-associated pneumonia.
Chest, 108 (1995), pp. 203-207
[68.]
S.R. Leal-noval, E. Alfaro-rodríguez, F. Murillo-Cabeza, J. Garnacho- Montero, J. Rey-pérez, M.A. Muñoz-Sanchez.
Diagnosis value of the blind brush in mechanically ventilated patients with nosocomial pneumonia.
Intensive Care Med, 18 (1992), pp. 410-414
Copyright © 2001. Sociedad Española de Neumología y Cirugía Torácica
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