Abstract：
Background: Despite its widespread use, there are no direct studies comparing mini-bronchoalveolar lavage (mini-BAL) to bronchoscopic bronchoalveolar lavage (BAL) for diagnosing pneumonia in ventilated patients. The aim of this study was to perform a systematic review of studies comparing ventilated patients undergoing both bronchoscopic BAL and mini-BAL, to determine the mini-BAL\'s diagnostic accuracy. Methods: We conducted a systematic review searching the databases PubMed (MEDLINE), EMBASE, Cochrane Library, Scopus, and clinicaltrials.gov from inception until January 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included variations on \"pneumonia,\" \"critical illness,\" and \"mini-bronchoalveolar lavage.\" Article screening and data extraction were performed independently by 2 reviewers. Results: Our search yielded 4296 abstracts. This was narrowed to 6 studies in which each patient underwent both mini-BAL and bronchoscopic BAL in succession. Included patients had a mean APACHE II score of 20.02 ± 3.81 and 15.95 ± 11.46 ventilator days. The sensitivity of the mini-BAL for diagnosis of pneumonia was 0.90 (95% confidence interval [CI]: 0.778-1.000) and the specificity was 0.827 (95% CI: 0.716-0.938). Limitations included inconsistency in volume of saline instilled and heterogeneity in included patients Conclusion: This study is the first to compile data from multiple publications directly comparing the mini-BAL to bronchoscopic BAL for diagnosing pneumonia in ventilated patients. Our data demonstrate a high degree of both sensitivity and specificity of mini-BAL for the diagnosis of pneumonia in ventilated patients and indicate that mini-BAL could be considered as an acceptable alternative diagnostic study.
摘要：
背景：尽管它的广泛使用，目前尚无直接研究比较小型支气管肺泡灌洗术(mini-BAL)与支气管镜支气管肺泡灌洗术(BAL)对通气患者肺炎的诊断价值.这项研究的目的是对接受支气管镜BAL和mini-BAL的通气患者进行系统评价。以确定mini-BAL的诊断准确性。方法：我们对PubMed(MEDLINE)数据库进行了系统评价，EMBASE,科克伦图书馆,Scopus,和clinicaltrials.gov从开始到2022年1月，按照系统审查和荟萃分析指南的首选报告项目。搜索词包括“肺炎”的变体，\"\"危重病,“和”微型支气管肺泡灌洗。“文章筛选和数据提取由2名评审员独立进行。结果：我们的搜索产生了4296篇摘要。这被缩小到6项研究，其中每位患者相继接受了微型BAL和支气管镜BAL。纳入患者的平均APACHEII评分为20.02±3.81和15.95±11.46呼吸机天。mini-BAL诊断肺炎的敏感性为0.90（95％置信区间[CI]：0.778-1.000），特异性为0.827（95％CI：0.716-0.938）。局限性包括生理盐水滴注量的不一致和纳入患者的异质性结论：这项研究是第一个从多个出版物中收集数据，直接比较mini-BAL与支气管镜BAL以诊断通气患者的肺炎。我们的数据表明，mini-BAL对通气患者肺炎的诊断具有高度的敏感性和特异性，并表明mini-BAL可被视为可接受的替代诊断研究。
