Comparison of the Patient Diagnostic Yield of Fibre-optic Bronchoscopy with Conventional Tracheal Aspirate

  • Subodh Sagar Dhakal OM Hospital and Research center
  • Navin Kumar Mishra OM Hospital and Research center
  • Karuna Bhatta OM Hospital and Research center
  • Milan Shrestha Kathmandu Medical College Teaching Hospital, Kathmandu
  • Rohit Karna Kathmandu Medical College Teaching Hospital, Kathmandu
  • Arjan Khanal Kathmandu Medical College Teaching Hospital, Kathmandu
Keywords: Broncho Alveolar Lavage, Intensive care Unit, Tracheal Aspirate

Abstract

Objective: To know the efficacy of Bronchoalveolar Lavage (BAL) in establishing diagnosis and its impact on overall health status of the patients.

Methods: A single center, longitudinal study involving 40 patients aged > 18 years old with septic shock with similar baseline characteristics was conducted. Two study arms, 20 patients in intervention arm - patient with utilization of Bronchoscopy and BAL in aiding diagnosis and 20-patients in conservative- arm without Bronchoscopy were compared in terms of establishing diagnosis primarily and secondarily in terms of length of stay and 30-day mortality. We were able to identify following organisms in BAL sample: Mycobacterium tuberculosis- 4, Acinetobacter baumanii- 3, Pseudomonasaeruginosa- 2, Klebsiella oxytica- 2, E. coli- 2, Streptococcus pneumoniae- 2, Staphyloccus aureus-

Results: We were able to identify various infectious agents as mentioned above 16/20 in BAL group compared to 8/20 in conventional arm; neoplasm in 4 out of 20 subjects in BAL group. In 80% of cases, BAL helped in identifying the organisms compared to only 40% in tracheal aspirate group. In addition, six cases in Intervention arm vs. nine cases in conventional arm had more than > 14 days hospital stay with the p-value 0 .492091. Interventional arm had lesser mortality 5 cases vs. 7 cases in Conventional arm with the p-value of 0.490153 which was not statistically significant.

Conclusion: We conclude that the diagnostic bronchoscope and related procedures among critically ill patients are helpful in identifying the pathogens and in detecting malignancy.

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Author Biographies

Subodh Sagar Dhakal, OM Hospital and Research center

Consultant Physician

Navin Kumar Mishra, OM Hospital and Research center

MD- Respiratory Medicine, Consultant
Pulmonologist

Karuna Bhatta, OM Hospital and Research center

Department of Internal Medicine

Milan Shrestha, Kathmandu Medical College Teaching Hospital, Kathmandu

Medicine Resident Doctor

Rohit Karna, Kathmandu Medical College Teaching Hospital, Kathmandu

Medicine Resident Doctor

Arjan Khanal, Kathmandu Medical College Teaching Hospital, Kathmandu

Medicine Resident Doctor

Published
2020-07-26
How to Cite
Dhakal, S., Mishra, N., Bhatta, K., Shrestha, M., Karna, R., & Khanal, A. (2020). Comparison of the Patient Diagnostic Yield of Fibre-optic Bronchoscopy with Conventional Tracheal Aspirate. Journal of BP Koirala Institute of Health Sciences, 3(1), 66-72. https://doi.org/10.3126/jbpkihs.v3i1.30329
Section
Original Articles