Tracheal aspirate with closed suction device: a modified technique developed during COVID-19 outbreak.

Schverdfinger, S.; Carboni Bisso, I.; Famiglietti, R.; Di Grazia, M.; Di Stefano, S.; Las Heras, M.

Background: Bacterial superinfection as well as ventilation associated pneumonia (VAP) are both frequent events in critical care. During COVID-19 pandemic, usual diagnostic practices such as bronchoalveolar lavage and tracheal aspirate are limited due to their associated high risk of exposure for the operator. In order to set primary focus on the protection of health care personnel, a modified tracheal aspiration (M-TA) technique is developed and used for acquiring a lower respiratory tract of microbiological samples with a closed suction device. Method: Retrospective observational study to evaluate effectiveness of M-TA is conducted. Results: A total of 33 M-TA samples were analyzed. In 66,6% of the cases, results led to a change in medical decision making. A 100% accuracy was achieved regarding COVID-19 diagnosis and a 56% bacterial growth-rate in cultives where VAP was suspected. No health care personnel have developed symptoms nor tested positive for COVID-19 during or after sample collection. Conclusion: M-TA technique presented could be considered as a safe and effective procedure with low percentage of complications.