Use of a central laboratory for analysis of bronchoalveolar lavage fluid

The logistics and related costs were assessed for providing analysis of bronchoalveolar lavage (BAL) fluid in a central laboratory for practicing pulmonologists in the area around New Haven, Connecticut. During a 4-yr period (1981-1985) we arranged for a courier service to transport 175 BAL specimens, obtained by 22 participating physicians at the time of fiberoptic bronchoscopy, directly to our laboratory. A large battery of information was generated on each specimen, and the data were returned to the responsible physician within 24 h. Any remaining cells and the cell-free supernatants were used for additional research purposes. The primary benefits of this program included: rapid and standardized analysis of lavage fluid cell counts for the clinician to use along with historical and other more routine laboratory tests in guiding patient diagnosis and an augmented number of lavage specimens available to the academician for research purposes. The costs were judged to be reasonable but need to be factored into the overall costs of patient diagnostic evaluations.