Comparison of the Results of Bronchoalveolar Lavage Culture and Endotracheal Aspirate Culture in Intubated Critically Ill COVID-19 Patients

Study Overview
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Brief Summary
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Introduction: Secondary pneumonia is frequently seen in COVID-19 cases followed up intubated, and high mortality rates can be observed. Isolation of the agent with bronchoalveolar lavage (BAL) culture or endotracheal aspirate (ETA) culture may increase the success of treatment. This study aimed to retrospectively analyze the results of BAL and ETA cultures in intubated COVID-19 cases. Methods: We routinely apply BAL culture with bronchoscopy or ETA culture within the first 48 hours after intubating. We retrospectively screened cases who underwent BAL and ETA. They were divided into two groups: Group B and E. Evaluated parameters were compared in both groups. Results: Demographic data and blood test results were similar in both groups. Intensive care unit (ICU) and intubation durations, and culture positivity were statistically significantly higher in Group B. Although not statistically significant, the mortality rate was higher in Group E. The most growth microorganisms were Candida species. Conclusion: Mortality rates were consistent with the literature. Since the microorganism isolation rate is higher with BAL and antimicrobial treatment is applied more effectively; early deaths were prevented and stay periods were prolonged. In contrast, these durations were shorter in the ETA group due to higher mortality. In intubated COVID-19 cases, a more effective treatment process can be carried out by clearing the airway with fiberoptic bronchoscopy and by specifically planning the treatment according to the BAL culture. This may have a positive effect on prognosis and mortality.

Official Title
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Comparison of the Results of Bronchoalveolar Lavage Culture and Endotracheal Aspirate Culture in Intubated Critically Ill COVID-19 Patients

Conditions
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Bronchoalveolar Lavage, COVID-19 Pneumonia, Critical Illness

Intervention / Treatment
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* Procedure: Bronchoalveolar lavage
* Procedure: endotracheal aspirate culture


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Intubated COVID-19 patients Above 18 years old patients Exclusion Criteria: Non COVID-19 patients Non intubated COVID-19 patients Below 18 years old patients

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group B (bronchoalveolar lavage)<br>Patients who underwent BAL* were named Group B * BAL: bronchoalveolar lavage | Procedure: Bronchoalveolar lavage<br>* In cases approved for bronchoscopy, bronchoalveolar lavage was performed and culture analysis was performed.<br>* Other names: fiberoptic bronchoscopy;|
| Group E (endotracheal aspirate)<br>Patients who received ETA** were named Group E. ** ETA: Endotracheal aspirate | Procedure: endotracheal aspirate culture<br>* In cases where consent for bronchoscopy could not be obtained, tracheal secretions were aspirated and culture analysis was performed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Culture positivity | Significantly higher microbiological culture growth rate was obtained in Group B | 1 years | 
| Length of stay in intensive care unit | Significantly higher duration of stay in intensive care unit was found in Group B | 1 years | 
| Duration of intubation | Significantly higher duration of stay intubated was observed in Group B | 1 years | 
| Mortality | Mortality rate was higher in Group E. But not statistically significant. | 1 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Microorganism | The most growing microorganism in both groups was the Candida species. | 1 years |