TY - JOUR T1 - Value of galactomannan in bronchoalveolar lavage fluid for invasive pulmonary aspergillosis in critically ill chronic obstructive pulmonary disease JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - 201 AU - Lin Ding AU - YongHang He AU - Fang Li AU - Qingyuan Zhan Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/201.abstract N2 - Backgroud: Critically ill COPD patients who require ICU admission are at particular risk of invasive pulmonary aspergillosis (IPA).Objective: To investigate the value of galactomannan (GM) in BALF for rapid diagnosis and prognosis of IPA in critically ill COPD patients.Design: We investigated the clinical data of patients with severe COPD in RICU of Beijing Chaoyang Hospital from February 2009 to December 2009 prospectively. Patients were divided to proven, probable, possible, colonization and non-IPA group. Serum GM and BALF GM were done at the first day of RICU admission.Results: 50 patients were recruited in the study,and 34 patients had BALF samples which were classified as probable IPA, possible IPA (n=6), 2 colonization (n=2) and non-IPA group (n=17); According to the ROC curve, when chose 0.795 as the cut-off of BALF GM test, the sensitivity, specificity, positive and negative predictive value for probable IPA were 88.9%, 95.1%, 100% and 93.7%, respectively;All of the patients of IPA group were dead. The result of GM test in BALF with IPA group were mush higher than control group (2.88 vs 0.49, p=0.009). The mortality was mush higher in the patients whose GM test in BALF above 0.795 than the patients lower 0.795 (80% vs 17% p=0.001);Conclusions: Compare to serum GM and aspergillus culture, GM in BALF prove to be more useful in early diagnosis of IPA with critically ill COPD patients. 0.795 maybe a best cut-off in BALF GM detection. Besides,high GM value in BALF was associated with high mortality in a certain sense. ER -