Blind bronchial sampling showed 88% sensitivity and 82% specificity at 104 cfu/mL (kappa 0.68). Thus quantitative cultures of BBS appear to be simple, non invasive and useful tool in the diagnosis of VAP. The high accuracy of BBS is not unusual as VAP is usually secondary to the aspiration of colonized oro-pharyngeal secretions into the dependent areas of the lung (especially the right), which can easily be reached with a catheter passed blindly through the endotracheal tube (19). Papazian et al (30) showed the sensitivity of BBS (58%) was greater than that of PSB (42%) but less than that of BAL (93%) and the area under ROC of BBS was greater than that of PSB (p<0.05). The author concluded that BBS was preferable to PSB for the diagnosis of VAP.