Bronchoalveolar Lavage: Tests and Applications
نویسندگان
چکیده
Bronchoalveolar lavage (BAL) is a diagnostic procedure used for re covering cellular and non-cellular components of the epithelial lining fl uid of the alveolar and bronchial airspaces. Non-bronchoscopic BAL involves the insertion of simple catheters or balloon-type devices through an endotracheal tube, while bronchoscopic BAL involves the instillation and immediate withdrawal of pre-warmed sterile 0.9 % saline solution through the working channel of a fl exible bronchoscope, preferably in the middle lobe or the lingula. The parameters measured in BAL fl uid (BALF) include the percentage of the instilled normal saline that is recovered as well as various BALF cellular and non-cellular components. BAL is performed for diagnostic, therapeutic, and research purposes. The most important indication for BAL in children is in the work up of infectious diseases. Other indications for BAL include non-specifi c chronic respiratory symptoms, non-specifi c radiological fi ndings, and clinical symptoms suggestive of interstitial lung disease. BAL is still considered to be the gold standard for diagnosing chronic pulmonary aspiration. BAL is a welltolerated and safe procedure; however, on occasion, fever, cough, transient wheezing, and pulmonary infi ltrates have been observed, which usually resolve within 24 h.
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