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A simple method of bronchoalveolar lavage
1Department of Critical Care, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Anaesthesia and Intensive Care
|February 1, 1994
Summary
Nonbronchoscopic bronchoalveolar lavage (NB-BAL) using a simple catheter method is effective for pediatric intensive care patients. This safe technique yields adequate samples in most cases, providing valuable diagnostic information.
Area of Science:
- Pediatric Intensive Care Medicine
- Respiratory Medicine
- Diagnostic Microbiology
Background:
- Ventilated pediatric intensive care patients often require respiratory sample analysis.
- Traditional bronchoscopic bronchoalveolar lavage (BAL) can be invasive.
- A simpler, nonbronchoscopic method may offer a viable alternative.
Purpose of the Study:
- To evaluate the efficacy and safety of a simple nonbronchoscopic bronchoalveolar lavage (NB-BAL) technique.
- To assess the quality and diagnostic yield of samples obtained via NB-BAL.
- To compare NB-BAL results with other invasive procedures.
Main Methods:
- A retrospective review of 28 ventilated pediatric intensive care patients who underwent NB-BAL.
- NB-BAL involved blindly wedging an infant feeding catheter endobronchially and lavaging with saline.
- Sample adequacy and microbiological findings were analyzed.
Main Results:
- Adequate samples were obtained in 87% of NB-BAL procedures.
- Diagnostic information not available from tracheal aspirates was found in 71% of NB-BAL samples.
- NB-BAL results correlated with bronchoscopic BAL and lung biopsy findings; no significant complications occurred.
Conclusions:
- Nonbronchoscopic bronchoalveolar lavage (NB-BAL) using an infant feeding catheter is a simple, cost-effective method.
- This technique provides good quality alveolar samples in the majority of pediatric intensive care patients.
- NB-BAL is a safe and valuable diagnostic tool in this population.