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Updated: Mar 25, 2026

Bronchoalveolar Lavage BAL for Research; Obtaining Adequate Sample Yield
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Bronchoalveolar Lavage BAL for Research; Obtaining Adequate Sample Yield

Published on: March 24, 2014

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Complications of Paediatric Flexible Bronchoscopy with Six-Lobe Bronchoalveolar Lavage Performed Under General

Maria van Veelen1, Kelly Bakewell1, Christopher W A Jolley1

  • 1Department of Paediatric Respiratory Medicine, Staffordshire Children's Hospital at Royal Stoke, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent ST4 6QG, UK.

Pediatric Reports
|March 24, 2026
PubMed

Insights

Flexible bronchoscopy with six-lobe lavage in children is safe, with few major complications. Parents should anticipate an approximate 9% risk of delayed overnight discharge following the procedure.

Area of Science:

  • Pediatric Pulmonology
  • Interventional Pulmonology
  • Pediatric Anesthesia

Background:

  • Flexible bronchoscopy with bronchoalveolar lavage (BAL) is a key diagnostic tool in pediatric respiratory conditions.
  • Performing BAL from all six lobes under general anesthesia (GA) may offer comprehensive sampling but requires safety evaluation.

Purpose of the Study:

  • To prospectively identify intra-procedure complications of pediatric flexible bronchoscopy with six-lobe lavage.
  • To retrospectively determine rates of delayed discharge and hospital readmission following this procedure.

Main Methods:

  • A prospective review of 120 procedures (Aug 2023-Aug 2024) recorded intra-procedure and immediate post-procedure events.
  • A retrospective review of 502 procedures (Oct 2014-Aug 2023) analyzed discharge delays and readmissions.
  • All procedures were performed under general anesthesia (GA) with six-lobe BAL at a tertiary pediatric center.

Main Results:

  • 3.3% of children experienced significant desaturation requiring intervention; 9.2% had immediate post-procedure complications.
  • 8.5% of all procedures resulted in delayed overnight discharge; 3% re-attended within 48 hours.
  • 11% of children in the prospective group experienced hypothermia.

Conclusions:

  • Pediatric flexible bronchoscopy with six-lobe lavage under GA is a safe procedure with a low incidence of major complications when performed by experienced clinicians.
  • Parents should be informed about the approximately 9% risk of delayed overnight discharge.
Abstract

Keywords:
bronchoalveolar lavagebronchoscopycomplicationspaediatricrespiratory

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