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Titolo:
DIAGNOSTIC YIELD AND THERAPEUTIC IMPACT OF FLEXIBLE BRONCHOSCOPY IN LUNG-TRANSPLANT RECIPIENTS
Autore:
CHAN CC; ABISALEH WJ; ARROLIGA AC; STILLWELL PC; KIRBY TJ; GORDON SM; PETRAS RE; MEHTA AC;
Indirizzi:
CLEVELAND CLIN FDN,DEPT PULM & CRIT CARE MED,SECT BRONCHOL,A90,9500 EUCLID AVE CLEVELAND OH 44195 CLEVELAND CLIN FDN,DEPT PULM & CRIT CARE MED,SECT BRONCHOL CLEVELAND OH 44195
Titolo Testata:
The Journal of heart and lung transplantation
fascicolo: 2, volume: 15, anno: 1996,
pagine: 196 - 205
SICI:
1053-2498(1996)15:2<196:DYATIO>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
TELESCOPING PLUGGED CATHETER; BRONCHOALVEOLAR LAVAGE; ACUTE REJECTION; WORKING FORMULATION; INFECTION; PNEUMONIA; HEART; CYTOMEGALOVIRUS; STANDARDIZATION; NOMENCLATURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
40
Recensione:
Indirizzi per estratti:
Citazione:
C.C. Chan et al., "DIAGNOSTIC YIELD AND THERAPEUTIC IMPACT OF FLEXIBLE BRONCHOSCOPY IN LUNG-TRANSPLANT RECIPIENTS", The Journal of heart and lung transplantation, 15(2), 1996, pp. 196-205

Abstract

Background: Bronchoalveolar lavage and transbronchial biopsy are often used for definitive diagnosis of lung rejection and infection in lung transplant recipients. Although protected specimen brushing is of value in nosocomial bacterial pneumonia, its role in lung transplant recipients has not been widely reported. The aim of the study is to review the diagnostic yield and therapeutic impact of flexible bronchoscopywith the use of a combination of bronchoalveolar lavage, protected specimen brushing, and transbronchial biopsy in lung transplant recipients. Methods: We reviewed flexible bronchoscopy data in 83 lung transplant recipients between February 1990 and March 1995. Only those with bronchoalveolar lavage, protected specimen brushing, and transbronchialbiopsy were included in the analysis. There were 282 bronchoscopies performed for clinically suspected lung rejection or infection (clinical bronchoscopy) and 35 bronchoscopies for follow-up of a previously detected histologic abnormality (follow-up bronchoscopy). Results: The total yields for rejection and infection for clinical and follow-up bronchoscopies were 67.4% and 57.9%, respectively. Acute rejection was detected with transbronchial biopsy in 26.2% and 34.2% of clinical and follow-up bronchoscopies, respectively. Cytomegalovirus pneumonitis wasdetected with transbronchial biopsy in 4.0% and 11.4% of clinical andfollow-up bronchoscopies, respectively. Overall, bacteria was the most common cause of lower respiratory tract infection. When used together, protected specimen brushing and bronchoalveolar lavage were complementary techniques for detection of bacterial lower respiratory tract infection with a significantly higher proportion detected with protected specimen brushing (greater than or equal to 10(3) colony forming units/ml) compared with bronchoalveolar lavage (greater than or equal to 10(5) colony forming units/ml) (p < 0.001). Complications were hemorrhage (1.9%), pneumothorax (2.5%) and transient hypoxemia (10.5%). The results had an impact on management of rejection and infection in 57.8%of clinical and 39.5% of follow-up bronchoscopies. Conclusions: We conclude that bronchoscopy, with the use of a combination of bronchoalveolar lavage, protected specimen brushing, and transbronchial biopsy, is safe with a high diagnostic yield and therapeutic impact for treating lung transplant recipients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 15:01:04