Bronchoalveolar lavage during fiberoptic bronchoscopy: what has it brought to pulmonary medicine?

In the last 13 years, bronchoalveolar lavage has been widely used to study the mechanisms involved in the defense of the lower respiratory tract and in the pathogenesis of a variety of lung disorders. This technique, which is a relatively safe and simple extension of fiberoptic bronchoscopy, has been proved to be a powerful investigative tool with enormous potential since it has enhanced our knowledge on a variety of disorders, including interstitial lung diseases, lung destruction associated to cigarette smoking and, recently, bronchial asthma. In addition, bronchoalveolar lavage has also been utilized as an interesting test to help in the diagnostic procedures and in the management of patients with a variety of pulmonary diseases. Its actual importance in clinical respiratory medicine, however, is still under debate and the value of some suggested applications remains to be established.