|Title:||Thoracic Surgeons Performing Bronchoalveolar Lavage After Intubation Supports Best Practice Antibiotic Guidelines for Lung Resection|
|Author(s):||H Jones1, M AlAdaileh1, D O’Callaghan2, B Lynch3, KC Redmond1|
|Institution:||The Mater Misericordiae University Hospital|
|Poster:||Click to view poster|
The aim of this study was to examine the relationship between bronchoalveolar lavage (BAL) culture positivity and the development of post-operative pneumonia (POP) in patients undergoing lung cancer resection.
A retrospective analysis of bronchoalveolar (BAL) cultures taken at induction of anaesthesia in 100 patients undergoing lung cancer resection between 2014 and 2019 was performed. The influence of patient age, sex, lung function with COPD diagnosis on BAL culture positivity was analysed. Patients’ records were reviewed for development of POP. Statistical analysis was performed using stepwise logistic regression analysis.
For univariate analysis of risk factors, Student’s t-tests were used for continuous data, and Pearson’s chi-squared or Fisher’s exact test were used for categorical data. All P values were two-sided and results were considered signiﬁcant if P<0.05.
Twenty-six per cent of patients had a positive BAL culture at induction. Presence of COPD and predicted post-operative forced expiratory volume in one second (FEV1) <60% were risk factors for a positive BAL culture (p <0.001 and p < 0.05). Age and sex were not predictive of a positive BAL culture. POP developed in 17%, of whom 8 (47%) had a positive BAL culture. Age (p 0.038), COPD (p<0.005), PPO-FEV1 (p 0.001), surgical approach (p<0.005) and positive BAL (p 0.005) before surgery were signiﬁcant variables associated with POP after lung resection. Length of stay in patients who received targeted therapy to BAL was reduced significantly (p 0.027).
Four percent of patients undergoing lung cancer resection cultured a BAL organism resistant to recommended antibiotic prophylaxis. Preoperative BAL cultures can inform antibiotic strategies among those with POP and this will have a positive impact on the length of hospital stay.