About: Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study

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About: Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study
Creator	Kouatchet, Achille Boulain, Thierry Bourenne, Jeremy Colin, Gwenhaël Contou, Damien Coudroy, Rémi Cracco, Christophe Guervilly, Christophe Guillon, Antoine Helms, Julie Hoppe, Marie Janssen-Langenstein, Ralf Kamel, Toufik Lascarrou, Jean Meng, Paris Nay, Mai-Anh Quenot, Jean Roustan, Jérôme
Source	PMC
abstract	PURPOSE: To assess the benefit-to-risk balance of bronchoalveolar lavage (BAL) in intensive care unit (ICU) patients. METHODS: In 16 ICUs, we prospectively collected adverse events during or within 24 h after BAL and assessed the BAL input for decision making in consecutive adult patients. The occurrence of a clinical adverse event at least of grade 3, i.e., sufficiently severe to need therapeutic action(s), including modification(s) in respiratory support, defined poor BAL tolerance. The BAL input for decision making was declared satisfactory if it allowed to interrupt or initiate one or several treatments. RESULTS: We included 483 BAL in 483 patients [age 63 years (interquartile range (IQR) 53–72); female gender: 162 (33.5%); simplified acute physiology score II: 48 (IQR 37-61); immunosuppression 244 (50.5%)]. BAL was begun in non-intubated patients in 105 (21.7%) cases. Sixty-seven (13.9%) patients reached the grade 3 of adverse event or higher. Logistic regression showed that a BAL performed by a non-experienced physician (non-pulmonologist, or intensivist with less than 10 years in the specialty or less than 50 BAL performed) was the main predictor of poor BAL tolerance in non-intubated patients [OR: 3.57 (95% confidence interval 1.04–12.35); P = 0.04]. A satisfactory BAL input for decision making was observed in 227 (47.0%) cases and was not predictable using logistic regression. CONCLUSIONS: Adverse events related to BAL in ICU patients are not infrequent nor necessarily benign. Our findings call for an extreme caution, when envisaging a BAL in ICU patients and for a mandatory accompaniment of the less experienced physicians. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-019-05896-4) contains supplementary material, which is available to authorized users.
has issue date	2020-01-07(xsd:dateTime)
bibo:doi	10.1007/s00134-019-05896-4
bibo:pmid	31912201
has license	no-cc
sha1sum (hex)	5051ca4d0c159c2f384074bb5ad4a84254c8ba82
schema:url	https://doi.org/10.1007/s00134-019-05896-4
resource representing a document's title	Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study
has PubMed Central identifier	PMC7223716
has PubMed identifier	31912201
schema:publication	Intensive Care Med
resource representing a document's body	covid:5051ca4d0c159c2f384074bb5ad4a84254c8ba82#body_text
is schema:about of	named entity 'prospective' named entity 'BALANCE' named entity 'patients' named entity 'ICU' named entity 'cohort study' named entity 'ventilatory support' named entity '1.03' named entity 'pneumonia' named entity 'ventilator-associated pneumonia' named entity 'intubated' named entity 'general anesthesia' named entity 'probability' named entity 'NIV' named entity 'Physiology' named entity 'Odds ratios' named entity 'diagnostic tool' named entity 'lung biopsy' named entity 'adverse events' named entity 'critically ill' named entity 'clinically significant' named entity 'adverse event' named entity 'adverse events' named entity 'diuretics' named entity 'intensivist' named entity 'Logistic regression' named entity 'care providers' named entity 'observational studies' named entity 'adverse events' named entity 'lung biopsy' named entity 'control group' named entity 'intensivists' named entity 'adverse events' named entity 'Mann-Whitney' named entity 'arterial blood gases' named entity 'statistical significance' named entity 'anesthesia' named entity 'increased probability' named entity 'pathologist' named entity 'anesthesia' named entity 'high-risk' named entity 'intensivist' named entity 'oxygen therapy' named entity 'respiratory support' named entity 'immunosuppression' named entity 'intubated' named entity 'ordinal regression' named entity 'randomized trials' named entity 'oxygen therapy' named entity 'acute respiratory failure' named entity 'case report' named entity 'tracheal intubation' named entity 'Proportional odds model' named entity 'adverse events' named entity 'HFNC' named entity 'vital signs' named entity 'logistic regression' named entity 'pulmonologist' named entity 'high-resolution CT scan' named entity 'sputum' named entity 'Orléans' named entity 'oxygen' named entity 'volatilome' named entity 'informed consent' named entity 'bronchoscopy'

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