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BAL for pneumonia prevention in tracheostomy patients: a clinical trial study
Vejdan AK, Khosravi M
Pakistan Journal of Medical Sciences 2013 Jan-Mar;29(1):148-151
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the role of flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) on pneumonia prevention of tracheostomy patients in intensive care unit. METHODOLOGY: This clinical trial was conducted on 67 head-injury patients who needed tracheostomy. The eligible patients were divided into two groups of different methods for removing the airway secretions. In intervention group, FB and BAL was added to routine conventional methods for airway clearance. Patients were followed for signs and symptoms of pneumonia. RESULTS: The risk of nosocomial pneumonia decreased from 35% to 14% in intervention group. The days of hospital stay were significantly reduced with bronchoscopic method. CONCLUSIONS: Flexible bronchoscopy is recommended to all ICU admitted patients that have tracheostomy tube and high volume of secretion in their airways. It can not only prevent the pneumonia formation decrease the morbidity and mortality rate but it can even shorten the ICU stay time and consequently reduce the costs of treatment.

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