[Risks and side effects of diagnostic bronchoalveolar lavage in ventilated patients]

Bronchoalveolar lavage is used increasingly often as a diagnostic tool in critically ill patients undergoing mechanical ventilation. Most patients, even those with haemodynamic instability or respiratory failure, tolerate the procedure without marked adverse effects. A relatively small proportion of patients, however, will experience potentially deleterious side effects like prolonged deterioration of pulmonary mechanics, oxygen desaturation or sepsis-like symptoms. Despite all precautions, it is not possible to date to identify increased-risk patients beforehand. The potential benefits, namely, early diagnosis of an aetiological agent who is responsible for infection, must therefore be carefully weighted against the risks.