Diagnostik von Beatmungspneumonien: Grundlagen, Techniken, Ergebnisse, vorläufige Empfehlungen

Pneumologie

Volumn 50, Issue 10, 1996, Pages 718-731

  Ewig, S ^a   Pauker S ^a   Tasci, S ^a   Schafer H ^a   Luderitz B ^a  

^a UNIVERSITY HOSPITAL BONN   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ARTIFICIAL VENTILATION; BACTERIAL PNEUMONIA; BRONCHOSCOPE; CROSS INFECTION; DIFFERENTIAL DIAGNOSIS; EQUIPMENT DESIGN; HUMAN; INSTRUMENTATION; LUNG LAVAGE; MICROBIOLOGICAL EXAMINATION; MICROBIOLOGY; NEEDLE BIOPSY; REVIEW; SENSITIVITY AND SPECIFICITY;

BACTERIOLOGICAL TECHNIQUES; BIOPSY, NEEDLE; BRONCHOALVEOLAR LAVAGE FLUID; BRONCHOSCOPES; CROSS INFECTION; DIAGNOSIS, DIFFERENTIAL; EQUIPMENT DESIGN; HUMANS; MICROBIAL SENSITIVITY TESTS; PNEUMONIA, BACTERIAL; RESPIRATION, ARTIFICIAL; SENSITIVITY AND SPECIFICITY;

EID: 0030254162     PISSN: 09348387     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (90)

1. Andrews, C. P., J. J. Coalson, J. D. Smith, W. G. Johanson: Diagnosis of nosocomial bacterial pneumonia in acute, diffuse lung injury. Chest 80 (1981) 254-258
2. Aubas, S., P. Aubas, X. Capdevila, H. Darbas, J. P. Roustan, DuCailar: Bronchoalveolar lavage for diagnosing bacterial pneumonia in mechanically ventilated patients. Am. J. Respir. Crit. Care Med. 149 (1994) 850-866
3. Baker, A. M., D. L. Bowton, E. F. Haponik: Decision making in nosocomial pneumonia: An analytic approach to the interpretation of quantitative bronchoscopic cultures. Chest 107 (1995) 85-95
4. Bartlett, J. G., J. Alexander, J. Mayhew: Should fiberoptic bronchoscopy aspirates be cultured? Am. Rev. Respir. Dis. 114 (1977) 73-78
5. Bartlett, J. G., S. M. Finegold: Bacteriology of expectorated sputum with quantitative culture and wash techniques compared to transtracheal aspirates. Am. Rev. Respir. Dis. 117 (1978) 1019-1027
6. Baselski, V., M. El-Torky, J. J. Coalson, J. P. Griffin: The standardization of criteria for processing and interpreting laboratory specimens in patients with suspected ventilator-associated pneumonia. Chest 102 (1992) 571S-579S
7. Baughman, R. P., C. H. Bosken, R. G. Loudon, P. Hurbutise, T. Wesseler: Quantitaten of bronchoalveolar lavage with methylene blue. Am. Rev. Respir. Dis. 128 (1983) 266-270
8. Baughman, R. P., J. E. Thorpe, J. Staneck, M. Rashkin, P. T. Frame: Use of the protected specimen brush in patients with endotracheal or tracheostomy tubes. Chest 91 (1987) 233-237
9. Bell, R. C., J. J. Coalson, J. D. Smith, W. G. Johanson: Multiple organ system failure and infection in adult respiratory distress syndrome. Ann. Intern. Med. 99 (1983) 293-298
10. Celis, R., A. Torres, J. M. Gatell, M. Almela, R. Rodriguez-Roisin, Augusti-Vidal: Nosocomial pneumonia: a multivariate analysis of risk and prognosis. Chest 93 (1988) 318-324
11. Chastre, J., F. Viau, P. Brun, J. Pierre, M. C. Dauge, A. Bouchama, A. Akbesi, C. Gibert: Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patients. Am. Rev. Respir. Dis. 130 (1984) 924-929
12. Chastre, J., J. Y. Fagon, P. Soler, M. Bornet, Y. Domart, J. L. Trouillet, C. Gibert, A. J. Hance: Diagnosis of nosocomial bacterial pneumonia in intubated patients undergoing ventilation: comparison of the usefulness of bronchoalveolar lavage and the protected specimen brush. Am. J. Me. 85 (1988) 499-506
13. Chastre, J., J. Y. Fagon, P. Soler, Domart, J. Pierre, M. C. Dombret, C. Gibert, A. J. Hance: Quantification of BAL cells containing intracellular bacteria rapidly identifies ventilated patients with nosocomial pneumonia. Chest 95 (1989) 190S-192S
14. Chastre, J., J. Y. Fagon: Invasive diagnostic testing should be routinely used to manage ventilated patients with suspected pneumonia. Am. J. Respir. Crit. Care Med. 150 (1994) 570-574
15. Chastre, J., J. Y. Fagon, M. Bornet-Lesco, S. Calvat, M. C. Dombret, R. Ah Khani, F. Basset, C. Gibert: Evaluation of bronchoscopic techniques for the diagnosis of nosocomial pneumonia. Am. J. Respir. Crit. Care Med. 152 (1995) 231-240
16. Craven, D. E., L. M. Kunches, V. Kilinsky, D. A. Lichtenberg, J. J. Make, W. R. McCabe: Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation. Am. Rev. Respir. Dis. 133 (1986) 792-796
17. Craven, D. E., L. M. Kunches, D. A. Lichtenberg, N. R. Kollisch, A. Barry, T. C. Heeren, W. Me Cabe: Nosocomial infection and fatality in medical and surgical intensive care unit patients. Arch. Intern. Med. 148 (1988) 1161-1168
18. Dotson, R. G., S. K. Pingleton: The effect of antibiotic therapy on recovery in intracellular bacteria from bronchoalveolar lavage in
19. suspected ventilator-associated nosocomial pneumonia. Chest 103 (1993) 541-546
20. Dreyfuss, D., L. Mier, G. Le Bourdelles, K. Djedaini, P. Brun, Y. Boussougant, F. Coste: Clinical significance of borderline quantitative protected brush specimen culture results. Am. Rev. Respir. Dis. 147 (1993) 946-951
21. El-Ebiary, M., A. Torres, J. Gonzalez, P. De La Bellacasa, C. Garcia, J. De Anta, M. Ferrer, R. Rodriguez-Roisin: Quantitative cultures of endotracheal aspirates for the diagnosis of ventilator-associated pneumonia. Am. Rev. Respir. Dis. 148 (1993) 1552-1557
22. El-Ebiary, M., A. Torres, J. Gonzalez, P. De La Bellacasa, M. Ferrer, R. Rodriguez-Roisin: Use of elastin fibre detection in the diagnosis of ventilator associated pneumonia. Thorax 50 (1995) 14-17
23. Fagon, J. Y., J. Chastre, A. J. Hance, M. Guiguet, J. L. Trouillet, Y. Domart, J. Pierre, C. Gibert: Detection of nosocomial lung infection in ventilated patients. Use of a protected specimen brush and quantiative culture techniques in 147 patients. Am. Rev. Respir. Dis. 138 (1988) 110-116
24. Fagon, J. Y., J. Chastre, Y. Domart, J. L. Trouillet, J. Pierre, C. Darne, C. Gibert: Nosocomial pneumonia in patients receiving continuous mechanical ventilation. Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture technique. Am. Rev. Respir. Dis. 139 (1989) 877-884
25. Fagon, J. Y., J. Chastre, J. L. trouillet, Y. Domart, M. C. Dombret, M. Bornet, C. Gibert: Characterisation of distal bronchial microflora during acute exacerbation of chronic bronchitis. Use of the protected specimen brush technique in 54 mechanically ventilated patients. Am. Rev. Respir. Dis. 142 (1990) 1004-1008
26. Fagon, J. Y. J. Chastre, A. J. Hance, P. Montravers, A. Novara, C. Gibert: Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am. J. Med. 94 (1993) 281-288
27. Fagon, J. Y., J. Chastre, A. J. Hance, Y. Domart, J. L. Trouillet, C. Gibert: Evaluation of clinical judgement in the identification and treatment of nosocomial pneumonia in ventilated patients. Chest 103 (1993) 547-553
28. Gaussorgues, P., D. Piperno, P. Bachmann, F. Boyer, G. Jean, M. Gerard, P. Leger, D. Robert: Comparison of nonbronchoscopic bronchoalveolar lavage to open lung biopsy for the bacteriologic diagnosis of pulmonary infections in mechanically ventilated patients. Intensive Care Med. 15 (1989) 94-98
29. Guerra, L. F., R. P. Baughman: Use of bronchoalveolar lavage to diagnose bacterial pneumonia in mechanically ventilated patients. Crit. Care Med. 18 (1990) 169-173
30. Hanley, J. A., B. J. McNeil: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143 (1982) 29-36
31. Hanley, J. A., B. J. McNeil: A method of comparing areas under receiver operating curves derived from the same cases. Radiology 148 (1983) 839-843
32. Higuchi, J. G., J. J. Coalson, W. G. Johanson: Bacteriologic diagnosis of nosocomial pneumonia in primates. Usefulness of the protected specimen brush. Am. Rev. Respir. Dis. 125 (1982) 53-57
33. Johanson, W. G., A. K. Pierce, J. P. Sandford, G. D. Thomas: Nosocomial respiratory infections with gram-negative bacilli: the significance of colonization of the respiratory tract. Ann. Intern. Med. 77 (1972) 701-706
34. Johanson, W. G., J. J. Seidenfeld, P. Gomez, R. De Los Santos, J. J. Coalson: Bacteriologic diagnosis of nosocomial pneumonia following prolonged mechanical ventilation. Am. Rev. Respir. Dis. 137 (1988) 259-264
35. Jorda, R., F. Parras, J. Ibanez, J. Reina, J. Bergada, J. M. Raurich: Diagnosis of nosocomial pneumonia in mechanically ventilated patients by the blind protected telescoping catheter. Intensive Care Med. 19 (1993) 377-382
36. Joshi, J. H., K. P. Wang, C. A. De Jongh, K. A. Newman, P. H. Wiernick, S. C. Schimpff: A comparative evaluation of two fiberoptic bronchoscopy catheters: the plugged telescoping catheter versus the single sheared nonplugged catheter. Am. Rev. Respir. Dis. 126 (1982) 860-863
37. Jourdain, B., A. Novara, Joly-Guillou, M. C. Dombret, S. Clavat, J. L. Trouillet, C. Gibert, J. Chastre: Role of quantitative cultures of endotracheal aspirates in the diagnosis of nosocomial pneumonia. Am. J. Respir. Crit. Care Med. 152 (1995) 241-246
38. Kahn, F. W., J. M. Jones: Diagnosing bacterial respiratory infection by bronchoalveolar lavage. J. Infect. Dis. 155 (1987) 862-869
39. Kirkpatrick, M. B., J. B. Bass jr.: Quantitative bacterial cultures of bronchoalveolar lavage fluids and protected brush catheter specimens from normal subjects. Am. Rev. Respir. Dis. 139 (1989) 546-548
40. Kollef, M. H., K. R. Bock, R. D. Richards, M. L. Hearns: The safety and diagnostic accuracy of minibronchoalveolar lavage in patients with suspected ventilator-associated pneumonia. Ann. Intern. Med. 122 (1995) 743-748
41. Lambert, R. S., L. E. Vereen, R. B. George: Comparison of tracheal aspirates and protected brush catheter specimens for identifying pathogenic bacteria in mechanically ventilated patients. Am. Med. J. Sci. 297 (1989) 377-382
42. Langer, M., P. Mosconi, M. Cigada, M. Mandelli and The Intensive Care Unit Group of Infection Control: Long-term respiratory support and risk of pneumonia in critically ill patients. Am. Rev. Respir. Dis. 140 (1989) 302-305
43. Leal-Noval, S. R., E. Alfaro-Rodriguez, F. Murillo-Cabeza, J. Garnacho-Montero, J. Rey-Perez, M. A. Munoz-Sanchez: Diagnostic value of the blind brush in mechanically ventilated patients with nosocomial pneumonia. Intensive Care Med. 18 (1992) 410-414
44. Leu, H. S., D. L. Kaiser, M. Mori, R. F. Woolson, R. P. Wenzel: Hospital-acquired pneumonia - attributable mortality and morbidity. Am. J. Epidemiol. 129 (1989) 1258-1267
45. Marquette, CH., P. Ramon, R. Courcol, B. Wallaert, A. B. Tonnel, C. Voisin: Bronchoscopic protected catheter brush for the diagnosis of pulmonary infections. Chest 93 (1988) 746-750
46. Marquette, C. H., F. Herengt, F. Sauliner, R. Nevierre, D. Mathieu, R. Courcol, P. Ramon: Protected specimen brush in the assessment of ventilator-associated pneumonia. Selection of a certain lung segment for bronchoscopic sampling is unnecessary. Chest 103 (1993) 243-247
47. Marquette, C. H., F. Herengt, D. Mathieu, F. Sauliner, R. Courchol, P. Ramon: Diagnosis of pneumonia in mechanically ventilated patients. Repeatability of the protected specimen brush. Am. Rev. Respir. Dis. 147 (1993) 211-214
48. Marquette, C. H., H. Georges, F. Wallet, P. Ramon, F. Saulnier, R. Niviere, D. Mathieu, A. Rime, A. B. Tonnel: Diagnostic efficiency of endotracheal aspirates with quantitative bacterial cultures in intubated patients with suspected pneumonia. Comparison with the protected specimen brush. Am. Rev. Respir. Dis. 148 (1993) 138-144
49. Marquette, C. H., F. Wallet, R. Neviere, M. C. Copin, F. Saulnier, J. N. Drault, H. Mehdaouit, D. Mathieu, P. Ramon: Diagnostic value of direct examination of the protected specimen brush in ventilator-associated pneumonia. Eur. Respir. J. 7 (1994) 105-113
50. Marquette, C. H., M. C. Copin, F. Wallet, R. Nevierte, F. Saulnier, D. Mathieu, A. Durocher, P. Ramonn, A. B. Tonnel: Diagnostic tests for pneumonia in ventilated patients: prospective evaluation of diagnostic accuracy using histology as a diagnostic gold standard. Am. J. Respir. Crit Care Med. 151 (1995) 1878-1997
51. Meduri, G. U.: Ventilator-associated pneumonia in patients with respiratory failure. A diagnostic approach. Chest 97 (1990) 1208-1219
52. Meduri, G. U., D. H. Beals, A. G. Maijub, V. Baselski: Protected bronchoalveolar lavage. A new bronchoscopic technique to re-
53. trieve uncontaminated distal airway secretions. Am. Rev. Respir. Dis. 143 (1991) 855-864
54. Meduri, G. U., R. G. Wunderink, K. V. Leeper, D. H. Beals: Management of bacterial pneumonia in ventilated patients. Protected bronchoalveolar lavage as a diagnostic tool. Chest 101 (1992) 500-508
55. Meduri, G. U., J. Chastre: The standardization of bronchoscopic techniques for ventilator-associated pneumonia. Chest 102 (1992) 5575-5645
56. Meduri, G. U., G. L. Mauldin, R. G. Wunderink, K. V. Leeper, C. B. Jones, E. Tolley, G. Mayhall: Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator-associated pneumonia. Chest 106 (1994) 221-235
57. Montravers, P., J. Y. Fagon, J. Chastre, M. Lesco, M. C. Dombret, J. L. Trouillet, C. Gibert: Follow-up protected specimen brushes to assess treatment in nosocomial pneumonia. Am. Rev. Respir. Dis. 147 (1993) 38-44
58. Niederman, M. S., A. Torres, W. Summer: Invasive diagnostic testing is not needed routinely to manage suspected ventilator-associated pneumonia. Am. J. Respir. Crit. Care Med. 150 (1994) 565-569
59. Papazian, L., C. Martin, B. Meric, J. F. Dumon, F. Gouin: Comparison of two methods of bacteriologic sampling of the lower respiratory tract: a study in ventilated patients with nosocomial bronchopneumonia. Crit. Care Med. 17 (1989) 461-464
60. Papazian, L., C. Martin, B. Meric, J. F. Dumon, F. Gouin: A reappraisal of blind bronchial sampling in the microbiologic diagnosis of nosocomial bronchopneumonia. Chest 103 (1993) 236-242
61. Papazian, L., P. Thomas, L. Garbe, I. Guignon, X. Thirion, J. Charrel, C. Bollet, P. Fuentes, F. Gouin: Bronchoscopic or blind sampling techniques for the diagnosis of ventilator-associated pneumonia. Am. J. Respir. Crit. Care Med. 152 (1995) 1982-1991
62. Pham, L. H., C. Brun-Buisson, P. Legrand, A. Rauss, F. Verra, L. Brochard, F. Lemaire: Diagnosis of nosocomial pneumonia in mechanically ventilated patients. Am. Rev. Respir. Dis. 143 (1991) 1055-1061
63. Pingleton, S. K., J. Y. Fagon, K. V. Leeper: Patient Selection for clinical investigation of ventilator-associated pneumonia - criteria for evaluating diagnostic techniques. Chest 102 (1992) 553S-556S
64. Pugin, J., R. Auckenthaler, N. Mili, J. P. Janssens, P. D. Lew, P. M. Suter: Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic "blind" bronchoalveolar lavage fluid. Am. Rev. Respir. Dis. 143 (1991) 1121-1129
65. Rello, J., E. Quintana, V. Ausina, J. Castella, M. Luquin, A. Net, G. Prats: Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients. Chest 100 (1991) 439-444
66. Rello, J., V. Ausina, M. Ricart, J. Castella, G. Prats: Impact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia. Chest 104 (1993) 1230-1235
67. Rello, J., A. Torres, M. Ricart, J. Valles, J. Gonzalez, A. Artigas, R. Rodriguez-Roisin: Ventilator-associated pneumonia by Staphylococcus aureus. Comparison of methicillin-resistant with methicillin-sensitive episodes. Am. J. Respir. Crit Care Med. 150 (1994) 1545-1549
68. Rennard, S., G. Basset, D. Lecossier, K. M. O'Donnell, P. Pinkston, P. G. Martin, R. G. Crystal: Estimations of the absolute volume of epithelial lining fluid recovered by bronchoalveolar lavage using urea as an endogenous marker of dilution. J. Appl. Physiol. 60 (1986) 532-538
69. Richard, C., M. Pezzano, B. Bouhaja, E. Rottman, A. Rimailho, B. Riou, P. Auzepy: Comparison of non-protected lower respiratory tract secretions and protected specimen brush samples in the diagnosis of pneumonia. Intensive Care Med. 14 (1988) 30-33
70. Rodriguez De Castro, F., J. S. Violan, B. L. Capuz, J. C. Luna, B. Gonzalez-Rodriguez, J. L. M. Alonso: Reliability of the bronchoscopic protected catheter brush in the diagnosis of pneumonia in mechanically ventilated patients. Crit. Care Med. 19 (1991) 171-175
71. Rouby, J. J., M. D. Rossignon, M. H. Nicolas, E. Martin de Lassale, S. Cristin, J. Grosset, P. Viars: A prospective study of protected bronchoalveolar lavage in the diagnosis of nosocomial pneumonia. Anesthesiology 71 (1989) 679-685
72. Rouby, J. J., E. Martin De Lassale, P. Poete, M. H. Nicolas, L. Bodin, V. Jarlier, Y. Le Charpentier, J. Grosset, P. Viars: Nosocomial bronchopneumonia in the critically ill. Am. Rev. Respir. Dis. 146 (1992) 1059-1066
73. Salata, R., M. M. Lederman, D. M. Shlaes, M. R. Jacobs, E. Eckstein, D. Tweardy, Z. Toossi, R. Chmielewski, J. Marino, C. H. King, R. C. Graham, J. J. Ellner: Diagnosis of nosocomial pneumonia in intubated, intensive care unit patients. Am. Rev. Respir. Dis. 135 (1987) 426-432
74. Shales, D. M., M. M. Lederman, R. Chmielewski, D. Tweardy, G. Krause, C. Safai: Sputum elastin fibers and the diagnosis of necrotizing pneumonia. Chest 85 (1984) 763-766
75. Thorpe, J. E., P. Baughman, P. T. Frame, A. Wesseler, J. L. Staneck: Bronchoavleolar lavage for diagnosing acute bacterial pneumonia. J. Infect. Dis. 155 (1987) 855-861
76. Timsit, J. F., B. Misset, S. Francoual, F. W. Goldstein, P. Vaury, J. Carlet: Is protected specimen brush a reproducible method to diagnose ICU-acquired pneumonia? Chest 104 (1993) 104-108
77. Torres, A., J. P. De la Bellacasa, R. Rodriguez-Roisin, M. T. Jimenez De Anta, A. Agusti-Vidal: Diagnostic value of telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia using the Metras catheter. Am. Rev. Respir. Dis. 138 (1988) 117-120
78. Torres, A., J. P. De La Bellacasa, A. Xaubet, J. Gonzalez, R. Rodriguez-Roisin, M. T. Jimenez De Anta, A. Agust-Vidal: Diagnostic value of quantitative cultures of bronchoalveolar lavage and telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia. Am. Rev. Respir. Dis. 140 (1989) 306-310
79. Torres, A., R. Aznar, J. M. Gatell, P. Jimenez, J. Gonzalez, A. Ferrer, R. Celis, R. Rodriguez-Roisin: Incidence, risk, and prognostic factors of nosocomial pneumonia in mechanically ventilated patients. Am. Rev. Respir. Dis. 142 (1990) 523-528
80. Torres, A., P. Jimenez, J. Puig de la Bellacasa, R. Celis, J. Gonzalez, J. Gea: Diagnostic value of nonfluoroscopic percutaneous lung needle aspiration in patients with pneumonia. Chest 98 (1990) 840-844
81. Torres, A., A. Martos, J. P. De La Bellacasa, M. Ferrer, M. El-Ebiary, J. Gonzalez, A. Gene, R. Rodriguez-Roisin: Specificity of endotracheal aspiration, protected specimen brush, and bronchoalveolar lavage in mechanically ventilated patients. Am. Rev. Respir. Dis. 147 (1993) 952-957
82. Torres, A., J. El-Ebiary, M. Gonzales, M. Ferrer, A. Puig de la Bellacasa, A. Gene, A. Martos, R. Rodriguez-Roisin: Gastric and pharyngeal flora in nosocomial pneumonia acquired during mechanical ventilation. Am. Rev. Respir. Dis. 148 (1993) 352-357
83. Torres, A., M. El-Ebiary, L. Padro, J. Gonzalez, J. P. De La Bellacasa, J. Ramirez, A. Xaubet, M. Ferrer, R. Rodriguez-Roisin: Validation of different techniques for the diagnosis of ventilator-associated pneumonia. Comparison with immediate postmortem pulmonary biopsy. Am. J. Crit. Care Med. 149 (1994) 324-331
84. Torzillo, P. J., D. B. McWilliam, I. H. Young, R. H. Woog, R. Benn: Use of protected telescoping brush system in the management of bacterial pulmonary infection in intubated patients. Br. J. Dis. Chest 79 (1985) 125-131
85. Valles, J., J. Rello, R. Fernandez, L. Blanch, F. Baigorri, J. Mestre, L. Matas, A. Marin, A. Artigas: Role of bronchoalveolar lavage in mechanically ventilated patients with suspected pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 13 (1994) 549-558
86. Wimberley, N., L. J. Paling, J. G. Bartlett: A fiberoptic bronchoscopy technique to obtain uncontaminated lower airway secretions for bacterial culture. Am. Rev. Respir. Dis. 119 (1979) 337-343
87. Winer-Muram, H. T., S. A. Rubin, J. V. Ellis, S. G. Jennings, K. L. Arheart, R. G. Wunderink, K. V. Leeper, G. U. Meduri: Pneumonia and ARDS in patients receiving mechanical ventilation: diagnostic accuray of chest radiography. Radiology 188 (1993) 479-485
88. Wunderink, R. G., L. S. Woldenberg, J. Zeiss, M. D. Day, J. Ciemiens, D. A. Lacher: The radiologic diagnosis of autopsy-proved ventilator-associated pneumonia. Chest 101 (1992) 458-558
89. Wunderink, R. G., C. G. Mayhall, C. Gibert: Methodology for clinical investigation of ventilator-associated pneumonia - epidemiology and therapeutic intervention. Chest 102 (1992) 581S-588S
90. Dr. med. S. Ewig Medizinische Universitätsklinik und Poliklinik Bonn Innere Medizin/Kardiologie und Pneumologie Sigmund-Freud-Straße 25 53105 Bonn