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Related Experiment Videos

Lidocaine concentrations in bronchoscopic specimens.

C Strange1, R A Barbarash, J E Heffner

  • 1Department of Medicine, Medical University of South Carolina, Charleston 29425.

Chest
|March 1, 1988
PubMed
Summary

Bronchoalveolar lavage (BAL) specimens have lower lidocaine concentrations than bronchial washings, making BAL suitable for pathogen cultures. Lidocaine levels in bronchial washings are not reliably reduced by timing or dosage adjustments.

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Area of Science:

  • Pulmonology
  • Anesthesiology
  • Clinical Microbiology

Background:

  • Lidocaine is commonly used during bronchoscopy.
  • The impact of lidocaine on specimen culture viability is a clinical concern.

Purpose of the Study:

  • To compare lidocaine concentrations in bronchoalveolar lavage (BAL) and bronchial washing specimens.
  • To assess factors influencing lidocaine concentrations in these specimens.

Main Methods:

  • Lidocaine concentrations were measured in BAL and bronchial washing samples obtained during bronchoscopy.
  • Specimens were categorized by collection method (BAL vs. bronchial washing) and timing (early vs. late).
  • Correlation with lidocaine dosage was analyzed.

Main Results:

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  • BAL lidocaine concentrations (16 ± 7 µg/mL) were significantly lower than bronchial washing concentrations (967 ± 379 µg/mL).
  • No significant difference in lidocaine levels was found between early and late bronchial washings.
  • High lidocaine concentrations (>5,000 µg/mL), potentially inhibiting pathogen growth, were found in some bronchial washings but not BAL specimens.
  • No clear correlation between lidocaine dose and measured concentrations was observed, though higher levels were noted with >250 mg lidocaine.

Conclusions:

  • BAL specimens are preferable for culturing mycobacterial and fungal pathogens due to lower lidocaine concentrations.
  • Collecting bronchial washings late in the procedure or adjusting lidocaine dosage does not reliably reduce inhibitory concentrations.
  • Clinicians should consider specimen type when assessing potential lidocaine inhibition of microbial growth.