Little is known about bronchoalveolar lavages performed for cytological assessment during bronchial fibroscopy in critically ill patients. Frequency of use, indications, actual contribution to diagnosis and therapeutic decision, and complications have not been extensively assessed. The primary objective of this multi center, prospective, observational study is to describe the frequency of use of bronchoalveolar lavages for cytological assessement in critically ill patients, identify their indications, assess their contribution to diagnosis and therapeutic decisions, and estimate the frequency of induced respiratory events.
Secondary objectives will be to * assess the frequency of poor quality bronchoalveolar lavages (as defined by either more than 5% bronchial epithelial cell count to less than 50,000 alveolar cells per mL) * assess the contribution of a given bronchoalveolar lavage to the diagnostic work up * assess the contribution of a given bronchoalveolar lavage results to therapeutic decision * assess the induced short term respiratory side effects * identify risk factors for poor respiratory tolerance
Study Type
OBSERVATIONAL
Enrollment
483
bronchoalveolar lavages performed for cytological assessment in critically ill patients with lung diseases, intubated or not
CHU d'ANGERS
Angers, France
CH d'ANGOULEME
Angoulême, France
CH Victor DUPOUY
Argenteuil, France
CHU de DIJON
Dijon, France
Hôpital RAYMOND POINCARE
Garches, France
CHD de VENDEE
La Roche-sur-Yon, France
CH de LA ROCHELLE
La Rochelle, France
Hopital de La Timone
Marseille, France
Hôpital Nord de Marseille
Marseille, France
CH de MONTAUBAN
Montauban, France
...and 6 more locations
quality of performed bronchoalveolar lavage
pathologists examining bronchoalveolar lavage specimen will classify bronchoalveolar lavage as "of poor quality" or of "good quality" based upon cytologic assessment: bronchial cell count (not more than 5%) and alveolar cell count (above 50,000/mL).
Time frame: 72 hours
contribution to diagnosis and/or therapeutic decision
Investigators will be ask to answer the following question: Did the bronchoalveolar lavage results contribute to diagnosis and/or therapeutic decision: Yes or No
Time frame: 72 hours
frequency of use
the frequency of use of bronchoalveolar lavage will be describe and expressed as the proportion of patients who underwent bronchoalveoalr lavage upon the total number of patients admitted in the recruiting intensive care units during the study period
Time frame: 72 hours
Evolution of respiratory rate
respiratory rate will be assessed before the bronchoalveolar lavage and 8 times during the 24 hours following the bronchoalveolar lavage
Time frame: 24 hours
Evolution of oxygen needs
Oxygen needs, in L/min in patients under conventional nasal or facial oxygen therapy, or expressed in FiO2 in patients under nasal high flow oxygen or under invasive or noninvasive ventilation, will be recorded before bronchoalveolar lavage and 8 times during the following 24 hours.
Time frame: 24 hours
Need of tracheal intubation
Percentage of patients not intubated while undergoing bronchoalveolar lavage that will need intubation within 24 hours
Time frame: 24 hours
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