Bronchoalveolar Lavage (BAL) : Critical Evaluation of Techniques

In the late 19(th) century, the rigid bronchoscope was pioneered by Chevalier Jackson and employed for the performance of bronchial lavage to wash purulent secretions from the airways of subjects with bronchiectasis in order to achieve symptomatic relief (1,2). The impetus of this work was rapidly advanced in the late 1960s by the development of fiberoptic technology and its application in the flexible fiberoptic bronchoscope by Ikeda (3). This instrument transformed the ease and convenience of bronchoscopy, opened it up for research procedures even in volunteers, and allowed development of novel sampling methods, including bronchoalveolar lavage (BAL).