TY - JOUR T1 - Evaluation of bronchoscopic findings and bronchoalveolar lavage (BAL) fluid cytology with regard to BAL fluid microbiology in critically ill patients JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2505 AU - Pavlos Venikos AU - Christos Kampolis AU - Konstantinos Konstantopoulos AU - Apostolos Armaganides AU - Petros Karakitsos Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2505.abstract N2 - Introduction: Bronchoscopy may be a useful diagnostic tool in critically ill patients with evolving pulmonary infiltrates and respiratory failure, especially when quick and exact diagnostic answers are required.Objectives: To evaluate a possible association between macroscopic appearance of respiratory secretions or BAL fluid cytology and BAL fluid microbiology, in mechanically ventilated (MV) patients with deterioration on chest radiography.Methods and patients: This prospective study included 52 consecutive MV patients (median age 72 yrs/ IQR:58-80) admitted to intensive care unit (ICU). Bronchoscopy and BAL was performed in all immunocompromised patients upon admission and in immunocompetent patients when diagnosis was uncertain.Results: Purulence of respiratory secretions was more frequent in patients with positive BAL cultures (for either one or more microbial pathogens), compared to patients with negative cultures (80% or 81.8% vs 46.2%) (p=0.060), and in patients with BAL cultures positive for Acinetobacter baumani or Pseudomonas aeruginosa compared to other pathogens (92.3% or 84.6% vs 62.5%) (p=0.045).The percentage of BAL fluid neutrophils did not seem to differ among patients with negative cultures, one or more isolated bacteria (p=0.435), or among patients with BAL cultures positive for different specific pathogens (p=0.352).Conclusions: In MV patients with radiologic deterioration, presence of purulent secretions revealed by bronchoscopy is associated with positive BAL cultures and isolation of specific gram negative pathogens. BAL differential cell profile does not differ according to BAL microbiology findings. ER -