Value of galactomannan in bronchoalveolar lavage fluid for invasive pulmonary aspergillosis in critically ill chronic obstructive pulmonary disease

Ref ID: 18399

Author:

Lin Ding, YongHang He, Fang Li, Qingyuan Zhan

Author address:

Respiratory and Critical
Care, Beijing Institute of Respiratory Medicine, Beijing, China Respiratory and
Critical Care, Beijing Institute of Respiratory Medicine, Beijing, China Infectious
Diseases and Clinical Microbiology, Beijing Institute of R

Full conference title:

European Respiratory Congress

Abstract:

Backgroud: Critically ill COPD patients who require ICU admission are at
particular risk of invasive pulmonary aspergillosis (IPA).
Objective: To investigate the value of galactomannan (GM) in BALF for rapid
diagnosis and prognosis of IPA in critically ill COPD patients.
Design: We investigated the clinical data of patients with severe COPD in RICU of
Beijing Chaoyang Hospital from February 2009 to December 2009 prospectively.
Patients were divided to proven, probable, possible, colonization and non-IPA
group. Serum GM and BALF GM were done at the first day of RICU admission.
Results: 50 patients were recruited in the study,and 34 patients had BALF samples
which were classified as probable IPA, possible IPA (n=6), 2 colonization (n=2)
and non-IPA group (n=17); According to the ROC curve, when chose 0.795 as the
cut-off of BALF GM test, the sensitivity, specificity, positive and negative predictive
value for probable IPA were 88.9%, 95.1%, 100% and 93.7%, respectively;All
of the patients of IPA group were dead. The result of GM test in BALF with IPA
group were mush higher than control group (2.88 vs 0.49, p=0.009). The mortality
was mush higher in the patients whose GM test in BALF above 0.795 than the
patients lower 0.795 (80% vs 17% p=0.001);
Conclusions: Compare to serum GM and aspergillus culture, GM in BALF prove
to be more useful in early diagnosis of IPA with critically ill COPD patients. 0.795
maybe a best cut-off in BALF GM detection. Besides,high GM value in BALF
was associated with high mortality in a certain sense.

Abstract Number: 201

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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