A simple method of bronchoalveolar lavage

Twenty-eight ventilated paediatric intensive care patients, mean age 4.1 +/- 4 years, who had had a simple method of nonbronchoscopic bronchoalveolar lavage (NB-BAL) performed were reviewed. The NB-BAL technique involved blindly wedging a 5 or 8F infant feeding catheter endobronchially and lavaging one millilitre per kg saline using a syringe. Adequate samples were collected in 87% of the NB-BAL specimens. In two of the four inadequate specimens, Pneumocystis carinii was still able to be identified. Additional information not obtained from the tracheal aspirate culture was seen in 71% of the NB-BAL samples. One-third of the patients also had a bronchoscopic BAL or a lung biopsy performed and the culture results were all identical to those obtained from NB-BAL. No significant complications were seen. Oxygenation and ventilation were not altered by the technique. We conclude that NB-BAL performed using a syringe and infant feeding catheter is a simple and cheap method that produces good alveolar samples in the majority of cases.