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Elastin fibers and the diagnosis of bacterial pneumonia in the adult respiratory distress syndrome.
Shepherd, K E; Lynch, K E; Wain, J C; Brown, E N; Wilson, R S.
Afiliación
  • Shepherd KE; Department of Anaesthesia, Harvard Medical School, Massachusetts General Hospital, Boston, USA.
Crit Care Med ; 23(11): 1829-34, 1995 Nov.
Article en En | MEDLINE | ID: mdl-7587258
OBJECTIVE: It has been inferred from previous work that 40% potassium hydroxide preparations of lower respiratory tract secretions that demonstrate elastin fibers have a 100% specificity and positive predictive value in diagnosing bacterial pneumonia in intubated, mechanically ventilated patients without the adult respiratory distress syndrome (ARDS). Our aim was to assess the specificity of 40% potassium hydroxide preparations in diagnosing bacterial pneumonia in patients with ARDS and suspected pneumonia. DESIGN: Prospective, case-referral clinical study. SETTING: Referral hospital. PATIENTS: Of 24 patients with ARDS who were intubated and mechanically ventilated with suspected bacterial pneumonia, 22 were assessable and evaluated for this report. INTERVENTIONS: Tracheo-bronchial aspirates were obtained from all patients and analyzed for elastin fibers using 40% potassium hydroxide. MEASUREMENTS AND MAIN RESULTS: Of the 22 assessable patients, ten patients did not have a complicating bacterial pneumonia. Six of these ten patients had potassium hydroxide preparations that demonstrated elastin fibers (false positives). The other four patients had preparations that did not demonstrate elastin fibers (true negatives). Specificity was 40%. CONCLUSION: Elastin fiber preparations are not specific for diagnosing bacterial pneumonia in patients with ARDS.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Líquido del Lavado Bronquioalveolar / Elastina / Neumonía Bacteriana Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Crit Care Med Año: 1995 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Líquido del Lavado Bronquioalveolar / Elastina / Neumonía Bacteriana Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Crit Care Med Año: 1995 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos