Chest Infections: Chest Infections: Bacterial |

Effect of Bronchoalveolar Lavage With Sodium Bicarbonate on Lower Respiratory Tract Pathogens FREE TO VIEW

Dina AbdAlla, MD; Mohammad El Badrawy, MD; Mohammad Abou Elela; Noha Abou El-khier; Taha Abdelgawad; Amro Moawad; Aida Yousef
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Mansoura Faculty of Medicine, Mansoura, Egypt

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A88. doi:10.1016/j.chest.2016.02.093
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SESSION TITLE: Chest Infections: Bacterial

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: All microbes grow within a particular range of external pH. Respiratory infections cause local acidosis that may inhibit bacterial killing by airway surface liquid. The present study was conducted to evaluate effect of bronchoalveolar lavage (BAL) with sodium bicarbonate (SB) 8.4% on the retrieved respiratory tract pathogens.

METHODS: Ninety three patients with lower respiratory tract infections (LRTI) enrolled in the study and assigned into 3 groups; 66 patients in group 1, 13 in group 2, and 14 in group 3. Patients in group 1 were subjected to BAL with 50 ml saline, followed by the same volume of SB from the same lobe. In group 2, BAL was done with 10 ml of saline followed by 50 ml SB followed by 50 ml saline. In group 3, BAL was done with 50 ml saline then the retrieved sample was divided into two equal volumes; one diluted with equal volume of saline and the other diluted with equal volume of SB. All samples were subjected to pH measurement, Gram staining, aerobic bacterial culture, Ziehl-Neelsen (ZN) staining, TB culture, fungal wet mount stain and fungal culture.

RESULTS:Klebsiella pneumoniae was the most common isolated bacteria in group 1 (22.86%). Candida albicans was the most common fungus retrieved in the three groups (37.9%, 30.8%, 14.3% respectively). There was a statistically significant decrease in median colony forming unit (CFU)/ml in SB samples when compared to saline in all groups for bacteria (p£0.001 for group 1, p=0.012 for group 2, and p=0.008 for group 3); and in group 1 and group 2 for fungi (p£0.001 and p= 0.027 respectively). There was a statistically significant difference between saline and SB in TB culture (p=0.031).

CONCLUSIONS: SB 8.4% BAL is inhibitory for bacterial, fungal, and mycobacterial growth in the specific cultures. No reported serious side effects in all patients.

CLINICAL IMPLICATIONS: BAL with SB 8.4% can be used safely in patients with LRTI to inhibit growth of organisms and accelerate the recovery process.

DISCLOSURE: The following authors have nothing to disclose: Dina AbdAlla, Mohammad El Badrawy, Mohammad Abou Elela, Noha Abou El-khier, Taha Abdelgawad, Amro Moawad, Aida Yousef

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