Assessment of the Diagnostic Capacity of the Mini-broncho Alveolar Lavage Performed Through a Suction Catheter

Study Overview
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Brief Summary
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The aim of this study is to develop a safe and effective technique to take sample for lower respiratory tract cultures easy to perform in conditions of acute respiratory failure and spontaneous ventilation for patients admitted in intensive care unit for acute infectious pneumonia and non intubated. The investigators perform sample collection with a mini bronchoalveolar lavage catheter introduced by nasotracheal way through a suction catheter. The purpose of the study is to assess the microbiological diagnostic capacity of this new technique.

Detailed Description
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At the moment we lack an effective and safe technique to obtain lower respiratory tract cultures for patient with mild serious infectious pneumonia admitted in intensive care unit and non intubated. Invasive procedure may worsen respiratory distress and non invasive procedure such expectorated sputum culture is not enough effective. The purpose of the study is to assess the microbiological diagnosis capacity of a new technique for taking samples from the lower respiratory tract: mini bronchoalveolar lavage performed by naso tracheal way through a suction catheter.Each consecutive patient admitted in intensive care unit for a community acquired or nosocomial pneumonia and not requiring intubation and mechanical ventilation will be included. Written informed consent by patient himself will be required. For each patient, after the introduction of a suction catheter, an endotracheal aspiration will be performed. Then, the mini bronchoalveolar lavage will be performed through the suction catheter with a specific catheter.The whole time of the procedure is about ten minutes.Expectorated sputum will also be ordered for each patient.This study is a pilot and prospective study.

Official Title
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Assessment of the Diagnostic Capacity of a New Sampling Technique for Lower Respiratory Tract Culture for Patients With Acute Infectious Pneumonia Admitted in Intensive Care Unit and Non Intubated.

Conditions
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Bacterial Pneumonia

Intervention / Treatment
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* Device: catheter for mini bronchoalveolar lavage


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age over 18 Radiological diagnosis of pneumonia (community acquired or nosocomial) No microbiological diagnosis known Indication for culture of lower respiratory tract Admission in intensive care unit required Exclusion Criteria: Age lower than 18 Bronchospasm Coagulopathy ( Platelets count below 100 000/mm3, prothrombin time less than 50%, activated partial thromboplastin time ratio higher than 2) Intubation with mechanical ventilation Known microbiological diagnosis Incapacity for consenting himself to the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Catheter for mini bronchoalveolar lavage | Device: catheter for mini bronchoalveolar lavage<br>* For each patient included an endotracheal aspiration and a mini bronchoalveolar lavage will be performed. After local anaesthesia, a suction catheter will be introduced in trachea by nasotracheal way. An endotracheal aspirate will be performed. Then, the mini bronchoalveolar lavage will be performed with the specific catheter introduced through the suction catheter. Expectorated sputum will also be ordered. This procedure will be performed once at the admission patient in intensive care unit.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The primary outcome measure is the rate of positive microbiological culture |  | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison between rate of positive culture obtain with mini bronchoalveolar lavage and the two others techniques used in the sudy: endotracheal aspiration and expectorated sputum |  | one year | 
| Feasibility of the procedure |  | ten minutes | 
| The acceptance of the procedure |  | ten minutes | 
| Physiological variables: heart and respiratory rate, oxygen saturation, blood pressure |  | before procedure and fifteen minutes after procedure | 
| If applicable: complications of the procedure |  | one day | 
| Time to obtain the result of the culture one day |  | one day | 
| Time of the procedure |  | one day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Community acquired pneumonia, Nosocomial pneumonia, Mini bronchoalveolar lavage, Endotracheal aspirates, Expectorated sputum