protected-specimen brush (PSB) technique has been used for almost 20
years in diagnosing pneumonia,1 and the technique
has been refined for VAP. Of the many studies, those included in our
analysis met certain criteria.
The 42 studies reviewed were identified through a MEDLINE search and
presented primary data of bronchoscopy samples from patients receiving
mechanical ventilation. All studies had rigorous clinical criteria for
the diagnosis of pneumonia, including response to antibiotics, that
were independent of the results of PSB or BAL procedures. The review
methodology for this section is described in Dr. Steven H. Woolf’s
section on the search of the literature.