Evidence map›Paper›PMID 38020848›Full record

ArticleCritical care explorations2023

Nonbronchoscopic Bronchoalveolar Lavage Improves Respiratory Culture Accuracy in Critically Ill Patients.

Margaret Jeng, Erica M Orsini, Jason Yerke, Omar Mehkri, Eduardo Mireles-Cabodevila, Hassan Khouli, Samin Mujanovic, Xiaofeng Wang, Abhijit Duggal, Vidula Vachharajani and 1 more

Open access · goldAbstract read
In one paragraph

Article in Critical care explorations, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Margaret JengDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Erica M OrsiniDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Jason YerkeDepartment of Pharmacy, Cleveland Clinic, Cleveland, OH.
Omar MehkriDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Eduardo Mireles-CabodevilaDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Hassan KhouliDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Samin MujanovicDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Xiaofeng WangQuantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.
Abhijit DuggalDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Vidula VachharajaniDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Rachel G ScheragaDepartment of Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Cleveland Clinic · USCleveland Clinic Lerner College of Medicine · US

Funding

TRPV4 Regulates Mechanosensitive Macrophage Functions in Lung InjuryR01HL155064 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI SCHERAGA, RACHEL GREENBERG · 2021 to 2025
$2.1M
Supporting Multidisciplinary Achievement in Respiratory Research Training (SMARRT)T32HL155005 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI Raed A. Dweik · 2021 to 2026
$1.9M
Immune Function in Sepsis: Role of SirtuinR35GM149240 · NIGMS · CLEVELAND CLINIC LERNER COM-CWRU · PI Vidula Vachharajani · 2023 to 2026
$1.6M
NHLBI NIH HHS R01 HL155064NHLBI NIH HHS T32 HL155005NIGMS NIH HHS R35 GM149240
6 · The paper itself

Abstract

objectivesDiagnosis of pneumonia is challenging in critically ill, intubated patients due to limited diagnostic modalities. Endotracheal aspirate (EA) cultures are standard of care in many ICUs; however, frequent EA contamination leads to unnecessary antibiotic use. Nonbronchoscopic bronchoalveolar lavage (NBBL) obtains sterile, alveolar cultures, avoiding contamination. However, paired NBBL and EA sampling in the setting of a lack of gold standard for airway culture is a novel approach to improve culture accuracy and limit antibiotic use in the critically ill patients.

designWe designed a pilot study to test respiratory culture accuracy between EA and NBBL. Adult, intubated patients with suspected pneumonia received concurrent EA and NBBL cultures by registered respiratory therapists. Respiratory culture microbiology, cell counts, and antibiotic prescribing practices were examined.

settingWe performed a prospective pilot study at the Cleveland Clinic Main Campus Medical ICU in Cleveland, Ohio for 22 months from May 2021 through March 2023. PATIENTS OR SUBJECTS: Three hundred forty mechanically ventilated patients with suspected pneumonia were screened. Two hundred fifty-seven patients were excluded for severe hypoxia (Fio

interventionsAll 83 eligible patients were enrolled and underwent concurrent EA and NBBL. MEASUREMENTS AND MAIN

resultsMore EA cultures (42.17%) were positive than concurrent NBBL cultures (26.51%,

conclusionsNBBL is more accurate than EA for respiratory cultures in critically ill, intubated patients. NBBL provides a safe and effective technique to sample the alveolar space for both clinical and research purposes.

Identifiers

PMID38020848
PMCPMC10656098
OpenAlexW4388744784

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.