Management of Suspected Ventilator-Associated Pneumonia
Authors: Jean-Yves Fagon
Journal: Annals of Internal Medicine (2000)

Letters19 December 2000Management of Suspected Ventilator-Associated PneumoniaJean-Yves Fagon, MD and Jean Chastre, MDJean-Yves Fagon, MDHôpital Européen Georges Pompidou; 75015 Paris, France (Fagon)Hôpital Bichat; 75018 Paris, France (Chastre)Search for more papers by this author and Jean Chastre, MDHôpital Européen Georges Pompidou; 75015 Paris, France (Fagon)Hôpital Bichat; 75018 Paris, France (Chastre)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-12-200012190-00021 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:In critically ill patients, fiberoptic bronchoscopy is well tolerated as long as usual contraindications are respected (1). In our study, no severe deleterious effects occurred. Different diagnostic techniques, including nondirected mini-bronchoalveolar lavage, have been tried, with apparently acceptable results. These “intermediate” techniques may reduce costs and simplify the procedure; unfortunately, in the absence of clear confirmation of preliminary findings, they cannot be recommended as the cornerstones of a diagnostic strategy. We agree with Dr. Johnson that semi-quantitative cultures can be considered an acceptable alternative microbiological technique to quantitative cultures for distinguishing colonizing pathogens from infecting pathogens. The approach ...References1. Jolliet P, Chevrolet JC. Bronchoscopy in the intensive care unit. Intensive Care Med. 1992;18:160-9. CrossrefMedlineGoogle Scholar2. Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med. 2000;162:505-11. CrossrefMedlineGoogle Scholar3. Cook D. Ventilator associated pneumonia: perspectives on the burden of illness. Intensive Care Med. 2000;26 Suppl 1 S31-7. CrossrefMedlineGoogle Scholar4. Alvarez-Lerma F. Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit. ICU-Acquired Pneumonia Study Group. Intensive Care Med. 1996;22:387-94. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Hôpital Européen Georges Pompidou; 75015 Paris, France (Fagon)Hôpital Bichat; 75018 Paris, France (Chastre) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInvasive and Noninvasive Strategies for Management of Suspected Ventilator-Associated Pneumonia Jean-Yves Fagon , Jean Chastre , Michel Wolff , Claude Gervais , Sylvie Parer-Aubas , François Stéphan , Thomas Similowski , Alain Mercat , Jean-Luc Diehl , Jean-Pierre Sollet , Alain Tenaillon , and Management of Suspected Ventilator-Associated Pneumonia James R. Johnson Management of Suspected Ventilator-Associated Pneumonia Santiago Ewig , Michael Niederman , and Antoni Torres Metrics Cited ByStructure of type II dehydroquinase from Pseudomonas aeruginosaStructure of 2-keto-3-deoxy- D - manno -octulosonate-8-phosphate synthase from Pseudomonas aeruginosaThin-section CT findings in Pseudomonas aeruginosa pulmonary infectionPneumonia Due to Pseudomonas aeruginosaPneumonia Due to Pseudomonas aeruginosaVentilator-associated pneumonia: an overviewVentilator-associated pneumonia: Lessons learned from clinical trialsPseudomonas aeruginosa : résistance et options thérapeutiques à l’aube du deuxième millénaireInappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsisPrevention and management of ventilator-associated pneumonia 19 December 2000Volume 133, Issue 12Page: 1009KeywordsBronchoalveolar lavageBronchoscopyDeath ratesDiagnostic techniquesEpidemiologyIntensive care unitsMortalityPathogensPneumoniaVentilator associated pneumonia ePublished: 19 December 2000 Issue Published: 19 December 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.Loading ...