Safety profile of blind bronchial sampling-A prospective study in pediatric intensive care unit.

OBJECTIVE: To study the safety profile of blind bronchial sampling in mechanically ventilated children.

DESIGN: Prospective interventional study.

SETTING: Tertiary level pediatric intensive care unit of a multispecialty hospital.

PATIENTS: Children aged 1 month to 16 years on mechanical ventilator for ≥48 h, were assessed by clinical pulmonary infection score for ventilator-associated pneumonia (VAP).

INTERVENTIONS: Blind bronchial sampling was performed following standard procedural guidelines. The hemodynamic, ventilation parameters, and arterial blood gases done before, and in next 24 h post procedure were recorded and compared.

MEASUREMENTS AND MAIN RESULTS: Among the 40 enrolled children, VAP was suspected at 5.8 ± 3.7 days post intubation with insignificant increase in median (IQR) PELOD score to 15 (11-23) from 13.5 (11-23) (P value 0.29). A statistically significant increase in mean blood pressure (75.5 ± 14.7 to 79.1 ± 14.2, P 0.04) and transient drop in SpO2 (98.2 ± 2.3 to 92.2 ± 9.2, P < 0.001) were noted with insignificant change in heart rate (128.7 ± 25.6 vs 132.0 ± 30.8, P 0.52), though these variations were clinically not significant. There were no major complications like significant airway bleed, arrhythmia, air leaks, edema, and change in pulmonary infiltrates during the procedure. There were no significant (either clinical or statistical) effects of BBS procedure, whether transient or prolonged, on ventilatory requirements or gas exchange parameters.

CONCLUSIONS: Blind bronchial sampling is a safe procedure in children with no major adverse events related to hemodynamics, oxygenation, and ventilation parameters.