Jump to content

Bronchoalveolar lavage: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous edit
Content deleted Content added
VisualWikitext
Updated existing text and added new citations, improved existing citations. Going to add a little more info now.
TheBartgry (talk | contribs)
458 edits
The procedure doesn't lead to these diseases
 
(35 intermediate revisions by 22 users not shown)
Line 1: Line 1:
{{Short description|Diagnostic method of the lower respiratory system}}
{{Infobox medical intervention
{{Infobox medical intervention
| name = Bronchoalveolar lavage
| name = Bronchoalveolar lavage
| pronounce = {{IPAc-en|ˌ|b|r|ɒ|ŋ|k|oʊ|ˌ|æ|l|v|i|ˈ|oʊ|l|ər|_|l|ə|ˈ|v|ɑː|ʒ|audio=En-us-bronchoalveolar-lavage.ogg}}
| pronounce = {{IPAc-en|ˌ|b|r|ɒ|ŋ|k|oʊ|ˌ|æ|l|v|i|ˈ|oʊ|l|ər|_|l|ə|ˈ|v|ɑː|ʒ|audio=En-us-bronchoalveolar-lavage.ogg}} {{respell|BRONG|koh|AL|vee|OH|lər|_|lə|VAHZH}}
| synonyms = Bronchoalveolar washing
| synonyms = Bronchoalveolar washing
| image =
| image =
| caption =
| caption =
| ICD10 =
| ICD10 =
| ICD9 = {{ICD9proc|33.24}}
| ICD9 = {{ICD9proc|33.24}}
| MeshID = D018893
| MeshID = D018893
| OPS301 =
| OPS301 =
| other codes =
| other codes =
}}
}}


'''Bronchoalveolar lavage''' ('''BAL''') (also known as '''bronchoalveolar washing''') is a diagnostic method of the lower respiratory system in which a [[bronchoscope]] is passed through the mouth or nose into an appropriate airway in the [[lung]]s, with a measured amount of fluid introduced and then collected for examination. This method is typically performed to [[medical diagnosis|diagnose]] pathogenic [[infection]]s of the lower respiratory airways<ref name="KahnDiag87">{{cite journal |title=Diagnosing bacterial respiratory infection by bronchoalveolar lavage |journal=Journal of Infectious Disease |author=Kahn, F.W.; Jones, J.M. |volume=155 |issue=5 |pages=826–9 |year=1987 |doi=10.1093/infdis/155.5.862 |pmid=3559290}}</ref><ref name="DemetriadesAtlas19-Ch6">{{cite book |url=https://books.google.com/books?id=co2CDwAAQBAJ&pg=PA50 |chapter=6. Bronchoscopy in the Intensive Care Unit |title=Atlas of Critical Care Procedures |author=Sugeir, S.; de Moraes, A.G. |editor=Demetriades, D.; Inaba, K. |publisher=Springer |page=50 |year=2019 |isbn=9783319783673}}</ref><ref name="DemetriadesAtlas19-Ch7">{{cite book |url=https://books.google.com/books?id=co2CDwAAQBAJ&pg=PA57 |chapter=7. Bronchoalveolar Lavage |title=Atlas of Critical Care Procedures |author=Warriner, Z.; Lewis, M. |editor=Demetriades, D.; Inaba, K. |publisher=Springer |pages=57–62 |year=2019 |isbn=9783319783673}}</ref>, though it also has been shown to have utility in diagnosing [[interstitial lung disease]].<ref name="MeyerAnOff12">{{cite journal |title=An official American Thoracic Society clinical practice guideline: The clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease |journal=American Journal of Respiratory and Critical Care Medicine |author=Meyer, K.C.; Raghu, G.; Baughman, R.P. |display-authors=etal |volume=185 |issue=9 |pages=1004–14 |year=2012 |doi=10.1164/rccm.201202-0320ST |pmid=22550210 |url=https://www.thoracic.org/statements/resources/interstitial-lung-disease/clinical-utility-blcaild.pdf |format=PDF}}</ref>
'''Bronchoalveolar lavage''' ('''BAL'''), also known as '''bronchoalveolar washing''', is a diagnostic method of the lower respiratory system in which a [[bronchoscope]] is passed through the mouth or nose into an appropriate airway in the [[lung]]s, with a measured amount of fluid introduced and then collected for examination. This method is typically performed to [[medical diagnosis|diagnose]] pathogenic [[infection]]s of the lower respiratory airways<ref name="KahnDiag87">{{cite journal |title=Diagnosing bacterial respiratory infection by bronchoalveolar lavage |journal=Journal of Infectious Diseases |author=Kahn, F.W. |author2=Jones, J.M. |volume=155 |issue=5 |pages=826–9 |year=1987 |doi=10.1093/infdis/155.5.862 |pmid=3559290}}</ref><ref name="DemetriadesAtlas19-Ch6">{{cite book |chapter-url=https://books.google.com/books?id=co2CDwAAQBAJ&pg=PA50 |chapter=6. Bronchoscopy in the Intensive Care Unit |title=Atlas of Critical Care Procedures |author=Sugeir, S. |author2=de Moraes, A.G. |editor=Demetriades, D.|editor2=Inaba, K. |publisher=Springer |page=50 |year=2019 |isbn=9783319783673}}</ref><ref name="DemetriadesAtlas19-Ch7">{{cite book |chapter-url=https://books.google.com/books?id=co2CDwAAQBAJ&pg=PA57 |chapter=7. Bronchoalveolar Lavage |title=Atlas of Critical Care Procedures |author=Warriner, Z. |author2=Lewis, M. |editor=Demetriades, D.|editor2=Inaba, K. |publisher=Springer |pages=57–62 |year=2019 |isbn=9783319783673}}</ref> (e.g. [[pneumonia]]<ref name="NietoTheRole95">{{cite journal |title=The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia |journal=European Journal of Clinical Microbiology and Infectious Diseases |author=Nieto, J.M.S. |author2=Alcaraz, A.C. |volume=14 |pages=839–50 |year=1995 |issue=10 |doi=10.1007/BF01691489 |pmid=8605896|pmc=7102128 }}</ref><ref name="JonkerBilateral12">{{cite journal |title=Bilateral versus unilateral bronchoalveolar lavage for the diagnosis of ventilator-associated pneumonia |journal=Surgical Infections |author=Jonker, M.A. |author2=Sauerhammer, T.M. |author3=Faucher, L.D. |display-authors=etal |volume=13 |issue=6 |pages=391–5 |year=2012 |doi=10.1089/sur.2011.081 |pmid=23240724 |pmc=3532003}}</ref><ref name="YangHigh15">{{cite journal |title=High-throughput sequencing of 16S rDNA amplicons characterizes bacterial composition in bronchoalveolar lavage fluid in patients with ventilator-associated pneumonia |journal=Drug Design, Development and Therapy |author=Yang, X.J. |author2=Wang, Y.B. |author3=Zhou, Z.W. |display-authors=etal |volume=9 |pages=4883–96 |year=2015 |doi=10.2147/DDDT.S87634 |pmid=26345636 |pmc=4554422 |doi-access=free }}</ref> and [[COVID-19]]<ref name="WHOLabTest20">{{cite journal |url=https://apps.who.int/iris/handle/10665/331501 |title=Laboratory testing for coronavirus disease (COVID-19) in suspected human cases: Interim guidance, 19 March 2020 |journal=WHO/COVID-19/Laboratory/2020.5 |author=World Health Organization |publisher=World Health Organization |date=19 March 2020 |hdl=10665/331501 |access-date=25 March 2020}}</ref><ref name="CDCInterim20">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html |title=Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19) |work=Coronavirus Disease 2019 (COVID-19) |author=Centers for Disease Control and Prevention |publisher=Centers for Disease Control and Prevention |date=25 March 2020 |access-date=25 March 2020}}</ref>), though it also has been shown to have utility in diagnosing [[interstitial lung disease]].<ref name="MeyerAnOff12">{{cite journal |title=An official American Thoracic Society clinical practice guideline: The clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease |journal=American Journal of Respiratory and Critical Care Medicine |author=Meyer, K.C. |author2=Raghu, G. |author3=Baughman, R.P. |display-authors=etal |volume=185 |issue=9 |pages=1004–14 |year=2012 |doi=10.1164/rccm.201202-0320ST |pmid=22550210 |url=https://www.thoracic.org/statements/resources/interstitial-lung-disease/clinical-utility-blcaild.pdf }}</ref> Bronchoalveolar [[lavage]] can be a more sensitive method of detection than nasal swabs in respiratory molecular diagnostics, as has been the case with SARS-CoV-2 where bronchoalveolar lavage samples detect copies of viral RNA after negative nasal swab testing.<ref>{{cite journal |title=Detection of SARS-CoV-2 by bronchoalveolar lavage after negative nasopharyngeal testing: Stay vigilant for COVID-19 |journal=Respiratory Medicine Case Reports |vauthors=Ramos KJ, Kapnadak SG, Collins BF, Wall R, Bryson-Cahn C, Perchetti GA, Jerome KR, Khot S, Limaye AP, Mathias PC, Greninger AL |author11-link=Alexander L. Greninger|author7-link=Keith R. Jerome|pages=101120 |year=2020 |volume=30 |doi=10.1016/j.rmcr.2020.101120 |pmid=32566476 |pmc=7298516 |doi-access=free }}</ref><ref name="RodrigoThera15">{{cite journal |title=Therapeutic limited bronchoalveolar lavage with fiberoptic bronchoscopy as a bridging procedure prior to total lung lavage in a patient with pulmonary alveolar proteinosis: A case report |journal=Journal of Medical Case Reports |author=Rodrigo, D. |author2=Rathnapala, A. |author3=Senaratne, W. |volume=9 |at=93 |year=2015 |doi=10.1186/s13256-015-0574-z |pmid=25925248 |pmc=4421915 |doi-access=free }}</ref>


In particular, bronchoalveolar lavage is commonly used to diagnose infections in people with [[immunocompromised|immune system problems]]<ref name="HendersonBroch94">{{cite journal |title=Bronchoalveolar lavage |journal=Archives of Disease in Childhood |author=Henderson, A.J. |volume=70 |issue=3 |pages=167–9 |year=1994 |doi=10.1136/adc.70.3.167 |pmid=8135556 |pmc=1029733}}</ref>, [[ventilator-associated pneumonia|pneumonia]] in people on [[mechanical ventilation|ventilators]]<ref name="JonkerBilateral12">{{cite journal |title=Bilateral versus unilateral bronchoalveolar lavage for the diagnosis of ventilator-associated pneumonia |journal=Surgical Infections |author=Jonker, M.A.; Sauerhammer, T.M.; Faucher, L.D. |display-authors=etal |volume=13 |issue=6 |pages=391–5 |year=2012 |doi=10.1089/sur.2011.081 |pmid=23240724 |pmc=3532003}}</ref><ref name="YangHigh15">{{cite journal |title=High-throughput sequencing of 16S rDNA amplicons characterizes bacterial composition in bronchoalveolar lavage fluid in patients with ventilator-associated pneumonia |journal=Drug Design, Development and Therapy |author=Yang, X.J.; Wang, Y.B.; Zhou, Z.W. |display-authors=etal |volume=9 |pages=4883-96 |year=2015 |doi=10.2147/DDDT.S87634 |pmid=26345636 |pmc=4554422}}</ref>, and [[acute respiratory distress syndrome]] (ARDS).<ref name="DemetriadesAtlas19-Ch7" /><ref name="WangLungFluid19">{{cite journal |title=Lung fluid biomarkers for acute respiratory distress syndrome: A systematic review and meta-analysis |journal=Critical Care |author=Wang, Y.; Wang, H.; Zhang, C. |display-authors=etal |volume=23 |at=43 |year=2019 |doi=10.1186/s13054-019-2336-6 |pmid=30755248 |pmc=6373030}}</ref> It is the most common method used to sample the epithelial lining fluid (ELF) and to determine the protein composition of the pulmonary airways.<ref name="DemetriadesAtlas19-Ch7" /><ref name="WangLungFluid19" /> BAL has even been used therapeutically to remove mucus, improve airway ventilation, and reduce airway inflammation in conditions such as [[chronic obstructive pulmonary disease]] (COPD) and [[pulmonary alveolar proteinosis]] (PAP).<ref name="DanelThera92">{{cite journal |title=Therapeutic applications of bronchoalveolar lavage |journal=European Respiratory Journal |author=Danel, C.; Israël-Biet, D.; Costabel, U.; Klech, H. |volume=5 |issue=10 |pages=1173–5 |year=1992 |pmid=1486961}}</ref><ref name="RodrigoThera15">{{cite journal |title=Therapeutic limited bronchoalveolar lavage with fiberoptic bronchoscopy as a bridging procedure prior to total lung lavage in a patient with pulmonary alveolar proteinosis: A case report |journal=Journal of Medical Case Reports |author=Rodrigo, D.; Rathnapala, A.; Senaratne, W. |volume=9 |at=93 |year=2015 |doi=10.1186/s13256-015-0574-z |pmid=25925248 |pmc=4421915}}</ref><ref name="ZhaoAnal18">{{cite journal |title=Analysis of curative effect of adjuvant therapy with bronchoalveolar lavage on COPD patients complicated with pneumonia |journal=Experimental and Therapeutic Medicine |author=Zhao, H.; Gu, H.; Liu, T.; Ge, J.; Shi, G. |volume=16 |issue=5 |pages=3799-3804 |year=2018 |doi=10.3892/etm.2018.6662 |pmid=30344655 |pmc=6176127}}</ref><ref name="MichaudWhole09">{{cite journal |title=Whole-lung lavage for pulmonary alveolar proteinosis |journal=Chest |author=Michaud, G.; Reddy, C.; Ernst, A. |volume=136 |issue=6 |pages=1678-1681 |year=2009 |doi=10.1378/chest.09-2295 |pmid=19995769}}</ref><ref name="CCHowLung14">{{cite web |url=https://health.clevelandclinic.org/how-lung-washing-helps-patients-breathe-again-video/ |title=How ‘Lung Washing’ Helps You Breathe Again |author=Cleveland Clinic |work=HealthEssentials |date=6 August 2014 |accessdate=25 March 2020}}</ref>
In particular, bronchoalveolar lavage is commonly used to diagnose infections in people with [[immunocompromised|immune system problems]],<ref name="HendersonBroch94">{{cite journal |title=Bronchoalveolar lavage |journal=Archives of Disease in Childhood |author=Henderson, A.J. |volume=70 |issue=3 |pages=167–9 |year=1994 |doi=10.1136/adc.70.3.167 |pmid=8135556 |pmc=1029733}}</ref> [[ventilator-associated pneumonia|pneumonia]] in people on [[mechanical ventilation|ventilators]],<ref name="JonkerBilateral12" /><ref name="YangHigh15" /> and [[acute respiratory distress syndrome]] (ARDS).<ref name="DemetriadesAtlas19-Ch7" /><ref name="WangLungFluid19">{{cite journal |title=Lung fluid biomarkers for acute respiratory distress syndrome: A systematic review and meta-analysis |journal=Critical Care |author=Wang, Y. |author2=Wang, H. |author3=Zhang, C. |display-authors=etal |volume=23 |at=43 |year=2019 |issue=1 |doi=10.1186/s13054-019-2336-6 |pmid=30755248 |pmc=6373030 |doi-access=free }}</ref> It is the most common method used to sample the [[epithelial lining fluid]] (ELF) and to determine the protein composition of the pulmonary airways.<ref name="DemetriadesAtlas19-Ch7" /><ref name="WangLungFluid19" />

BAL has even been used therapeutically to remove mucus ([[sputum]]), improve airway ventilation, and reduce airway inflammation in conditions such as [[chronic obstructive pulmonary disease]] (COPD)<ref name="ZhaoAnal18">{{cite journal |title=Analysis of curative effect of adjuvant therapy with bronchoalveolar lavage on COPD patients complicated with pneumonia |journal=Experimental and Therapeutic Medicine |author=Zhao, H. |author2=Gu, H. |author3=Liu, T. |author4=Ge, J. |author5=Shi, G. |volume=16 |issue=5 |pages=3799–3804 |year=2018 |doi=10.3892/etm.2018.6662 |pmid=30344655 |pmc=6176127}}</ref> and pediatric [[Mycoplasma pneumonia]].<ref name="pmid37798699">{{cite journal |last1=Wu |first1=X |last2=Lu |first2=W |last3=Wang |first3=T |last4=Xiao |first4=A |last5=Guo |first5=X |last6=Xu |first6=Y |last7=Li |first7=S |last8=Liu |first8=X |last9=Zeng |first9=H |last10=He |first10=S |last11=Zhang |first11=X |title=Optimization strategy for the early timing of bronchoalveolar lavage treatment for children with severe mycoplasma pneumoniae pneumonia. |journal=BMC Infectious Diseases |date=5 October 2023 |volume=23 |issue=1 |pages=661 |doi=10.1186/s12879-023-08619-9 |pmid=37798699 |pmc=10557288 |doi-access=free }}</ref> A much more intense version involving up to 50 liters of fluid is called [[whole lung lavage]] (WLL) and is used to treat [[pulmonary alveolar proteinosis]] (PAP).<ref name="MichaudWhole09">{{cite journal |title=Whole-lung lavage for pulmonary alveolar proteinosis |journal=Chest |author=Michaud, G. |author2=Reddy, C. |author3=Ernst, A. |volume=136 |issue=6 |pages=1678–1681 |year=2009 |doi=10.1378/chest.09-2295 |pmid=19995769}}</ref><ref name="CCHowLung14">{{cite web |url=https://health.clevelandclinic.org/how-lung-washing-helps-patients-breathe-again-video/ |title=How 'Lung Washing' Helps You Breathe Again |author=Cleveland Clinic |work=HealthEssentials |date=6 August 2014 |access-date=25 March 2020 |archive-date=14 August 2020 |archive-url=https://web.archive.org/web/20200814074306/https://health.clevelandclinic.org/how-lung-washing-helps-patients-breathe-again-video/ |url-status=dead }}</ref><ref name="DanelThera92">{{cite journal |title=Therapeutic applications of bronchoalveolar lavage |journal=European Respiratory Journal |author=Danel, C. |author2=Israël-Biet, D. |author3=Costabel, U. |author4=Klech, H. |volume=5 |issue=10 |pages=1173–5 |year=1992 |doi=10.1183/09031936.93.05101173 |pmid=1486961|s2cid=6265382 |doi-access=free }}</ref> When conditions disallow WLL, an endoscopic BAL can be used as a bridging procedure.<ref name="RodrigoThera15"/>

==Equipment and procedure==
The primary equipment used in BAL includes a fiber-optic bronchoscope, sterile collection traps for collecting test [[Sampling (medicine)|specimens]], a sterile [[Saline (medicine)|saline]] source, a [[Suction (medicine)|suction device]], and suction tubing.<ref name="DemetriadesAtlas19-Ch7" /> Essentially, the saline source is connected to sterile bronchoscope, as is the specimen collection trap, and then suction tubing is connected to the trap and the suction source. If the bronchoscope is not sterile, saline should initially be used to flush it clean. With the patient under some sort of anesthesia (depending on the rigidity of the scope), the fiber-optic cable is lowered into the correct area of the lower lungs ([[Respiratory tract#Lower respiratory tract|tracheobronchial tree]]), wedged into place, and saline applied. Once the saline is fully applied, then either suction is applied to collect the fluids, or the fluids are collected with a sterile syringe through the irrigation channel. The collection trap is then appropriately labeled and sent off for testing.<ref name="DemetriadesAtlas19-Ch7" />

Recent literature for the use of endoscopic BAL in therapy uses essentially the same process. A flexible bronchoscope is most commonly used. The physician seeks out areas with excess mucus or other abnormalities, then uses saline and suction to clean it.<ref>{{cite journal |last1=Wang |first1=Lijun |last2=Xie |first2=Qiuling |last3=Xu |first3=Shanshan |last4=Li |first4=Huajun |last5=Zhang |first5=Liya |last6=Ai |first6=Jingwen |last7=Liu |first7=Quanhua |last8=Chu |first8=Caiting |last9=Zhang |first9=Xi |last10=Zhang |first10=Wenhong |last11=Huang |first11=Lisu |title=The role of flexible bronchoscopy in children with Mycoplasma pneumoniae pneumonia |journal=Pediatric Research |date=January 2023 |volume=93 |issue=1 |pages=198–206 |doi=10.1038/s41390-021-01874-z|pmid=35459766 |s2cid=248326894 }}</ref><ref name="ZhaoAnal18"/>


==See also==
==See also==
* [[Asbestosis]]
* [[Asbestosis]]
* [[Asthma]]
* [[Asthma]]
* [[Chronic obstructive pulmonary disease]]
* [[Chronic obstructive pulmonary disease]]
* [[COVID-19]]
* [[Lung cancer]]
* [[Lung cancer]]
* [[Mesothelioma]]
* [[Mesothelioma]]
* [[Pneumoconiosis]]
* [[Silicosis]]
* [[Silicosis]]


==References==
==References==
{{reflist}}
{{Reflist}}



{{Respiratory system procedures}}
{{Respiratory system procedures}}
{{Authority control}}
{{Portal bar|Medicine}}


{{DEFAULTSORT:Bronchoalveolar Lavage}}
{{DEFAULTSORT:Bronchoalveolar Lavage}}
[[Category:Diagnostic pulmonology]]
[[Category:Respiratory system procedures]]
[[Category:Respiratory system procedures]]
[[Category:Medical tests]]

{{treatment-stub}}

Latest revision as of 18:18, 11 June 2024

Bronchoalveolar lavage
Pronunciation/ˌbrɒŋkoʊˌælviˈoʊlər ləˈvɑːʒ/ ⓘ BRONG-koh-AL-vee-OH-lər lə-VAHZH
Other namesBronchoalveolar washing
ICD-9-CM33.24
MeSHD018893

Bronchoalveolar lavage (BAL), also known as bronchoalveolar washing, is a diagnostic method of the lower respiratory system in which a bronchoscope is passed through the mouth or nose into an appropriate airway in the lungs, with a measured amount of fluid introduced and then collected for examination. This method is typically performed to diagnose pathogenic infections of the lower respiratory airways[1][2][3] (e.g. pneumonia[4][5][6] and COVID-19[7][8]), though it also has been shown to have utility in diagnosing interstitial lung disease.[9] Bronchoalveolar lavage can be a more sensitive method of detection than nasal swabs in respiratory molecular diagnostics, as has been the case with SARS-CoV-2 where bronchoalveolar lavage samples detect copies of viral RNA after negative nasal swab testing.[10][11]

In particular, bronchoalveolar lavage is commonly used to diagnose infections in people with immune system problems,[12] pneumonia in people on ventilators,[5][6] and acute respiratory distress syndrome (ARDS).[3][13] It is the most common method used to sample the epithelial lining fluid (ELF) and to determine the protein composition of the pulmonary airways.[3][13]

BAL has even been used therapeutically to remove mucus (sputum), improve airway ventilation, and reduce airway inflammation in conditions such as chronic obstructive pulmonary disease (COPD)[14] and pediatric Mycoplasma pneumonia.[15] A much more intense version involving up to 50 liters of fluid is called whole lung lavage (WLL) and is used to treat pulmonary alveolar proteinosis (PAP).[16][17][18] When conditions disallow WLL, an endoscopic BAL can be used as a bridging procedure.[11]

Equipment and procedure

[edit]

The primary equipment used in BAL includes a fiber-optic bronchoscope, sterile collection traps for collecting test specimens, a sterile saline source, a suction device, and suction tubing.[3] Essentially, the saline source is connected to sterile bronchoscope, as is the specimen collection trap, and then suction tubing is connected to the trap and the suction source. If the bronchoscope is not sterile, saline should initially be used to flush it clean. With the patient under some sort of anesthesia (depending on the rigidity of the scope), the fiber-optic cable is lowered into the correct area of the lower lungs (tracheobronchial tree), wedged into place, and saline applied. Once the saline is fully applied, then either suction is applied to collect the fluids, or the fluids are collected with a sterile syringe through the irrigation channel. The collection trap is then appropriately labeled and sent off for testing.[3]

Recent literature for the use of endoscopic BAL in therapy uses essentially the same process. A flexible bronchoscope is most commonly used. The physician seeks out areas with excess mucus or other abnormalities, then uses saline and suction to clean it.[19][14]

See also

[edit]

References

[edit]
  1. ^ Kahn, F.W.; Jones, J.M. (1987). "Diagnosing bacterial respiratory infection by bronchoalveolar lavage". Journal of Infectious Diseases. 155 (5): 826–9. doi:10.1093/infdis/155.5.862. PMID 3559290.
  2. ^ Sugeir, S.; de Moraes, A.G. (2019). "6. Bronchoscopy in the Intensive Care Unit". In Demetriades, D.; Inaba, K. (eds.). Atlas of Critical Care Procedures. Springer. p. 50. ISBN 9783319783673.
  3. ^ a b c d e Warriner, Z.; Lewis, M. (2019). "7. Bronchoalveolar Lavage". In Demetriades, D.; Inaba, K. (eds.). Atlas of Critical Care Procedures. Springer. pp. 57–62. ISBN 9783319783673.
  4. ^ Nieto, J.M.S.; Alcaraz, A.C. (1995). "The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia". European Journal of Clinical Microbiology and Infectious Diseases. 14 (10): 839–50. doi:10.1007/BF01691489. PMC 7102128. PMID 8605896.
  5. ^ a b Jonker, M.A.; Sauerhammer, T.M.; Faucher, L.D.; et al. (2012). "Bilateral versus unilateral bronchoalveolar lavage for the diagnosis of ventilator-associated pneumonia". Surgical Infections. 13 (6): 391–5. doi:10.1089/sur.2011.081. PMC 3532003. PMID 23240724.
  6. ^ a b Yang, X.J.; Wang, Y.B.; Zhou, Z.W.; et al. (2015). "High-throughput sequencing of 16S rDNA amplicons characterizes bacterial composition in bronchoalveolar lavage fluid in patients with ventilator-associated pneumonia". Drug Design, Development and Therapy. 9: 4883–96. doi:10.2147/DDDT.S87634. PMC 4554422. PMID 26345636.
  7. ^ World Health Organization (19 March 2020). "Laboratory testing for coronavirus disease (COVID-19) in suspected human cases: Interim guidance, 19 March 2020". WHO/COVID-19/Laboratory/2020.5. World Health Organization. hdl:10665/331501. Retrieved 25 March 2020.
  8. ^ Centers for Disease Control and Prevention (25 March 2020). "Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19)". Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. Retrieved 25 March 2020.
  9. ^ Meyer, K.C.; Raghu, G.; Baughman, R.P.; et al. (2012). "An official American Thoracic Society clinical practice guideline: The clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease" (PDF). American Journal of Respiratory and Critical Care Medicine. 185 (9): 1004–14. doi:10.1164/rccm.201202-0320ST. PMID 22550210.
  10. ^ Ramos KJ, Kapnadak SG, Collins BF, Wall R, Bryson-Cahn C, Perchetti GA, Jerome KR, Khot S, Limaye AP, Mathias PC, Greninger AL (2020). "Detection of SARS-CoV-2 by bronchoalveolar lavage after negative nasopharyngeal testing: Stay vigilant for COVID-19". Respiratory Medicine Case Reports. 30: 101120. doi:10.1016/j.rmcr.2020.101120. PMC 7298516. PMID 32566476.
  11. ^ a b Rodrigo, D.; Rathnapala, A.; Senaratne, W. (2015). "Therapeutic limited bronchoalveolar lavage with fiberoptic bronchoscopy as a bridging procedure prior to total lung lavage in a patient with pulmonary alveolar proteinosis: A case report". Journal of Medical Case Reports. 9. 93. doi:10.1186/s13256-015-0574-z. PMC 4421915. PMID 25925248.
  12. ^ Henderson, A.J. (1994). "Bronchoalveolar lavage". Archives of Disease in Childhood. 70 (3): 167–9. doi:10.1136/adc.70.3.167. PMC 1029733. PMID 8135556.
  13. ^ a b Wang, Y.; Wang, H.; Zhang, C.; et al. (2019). "Lung fluid biomarkers for acute respiratory distress syndrome: A systematic review and meta-analysis". Critical Care. 23 (1). 43. doi:10.1186/s13054-019-2336-6. PMC 6373030. PMID 30755248.
  14. ^ a b Zhao, H.; Gu, H.; Liu, T.; Ge, J.; Shi, G. (2018). "Analysis of curative effect of adjuvant therapy with bronchoalveolar lavage on COPD patients complicated with pneumonia". Experimental and Therapeutic Medicine. 16 (5): 3799–3804. doi:10.3892/etm.2018.6662. PMC 6176127. PMID 30344655.
  15. ^ Wu, X; Lu, W; Wang, T; Xiao, A; Guo, X; Xu, Y; Li, S; Liu, X; Zeng, H; He, S; Zhang, X (5 October 2023). "Optimization strategy for the early timing of bronchoalveolar lavage treatment for children with severe mycoplasma pneumoniae pneumonia". BMC Infectious Diseases. 23 (1): 661. doi:10.1186/s12879-023-08619-9. PMC 10557288. PMID 37798699.
  16. ^ Michaud, G.; Reddy, C.; Ernst, A. (2009). "Whole-lung lavage for pulmonary alveolar proteinosis". Chest. 136 (6): 1678–1681. doi:10.1378/chest.09-2295. PMID 19995769.
  17. ^ Cleveland Clinic (6 August 2014). "How 'Lung Washing' Helps You Breathe Again". HealthEssentials. Archived from the original on 14 August 2020. Retrieved 25 March 2020.
  18. ^ Danel, C.; Israël-Biet, D.; Costabel, U.; Klech, H. (1992). "Therapeutic applications of bronchoalveolar lavage". European Respiratory Journal. 5 (10): 1173–5. doi:10.1183/09031936.93.05101173. PMID 1486961. S2CID 6265382.
  19. ^ Wang, Lijun; Xie, Qiuling; Xu, Shanshan; Li, Huajun; Zhang, Liya; Ai, Jingwen; Liu, Quanhua; Chu, Caiting; Zhang, Xi; Zhang, Wenhong; Huang, Lisu (January 2023). "The role of flexible bronchoscopy in children with Mycoplasma pneumoniae pneumonia". Pediatric Research. 93 (1): 198–206. doi:10.1038/s41390-021-01874-z. PMID 35459766. S2CID 248326894.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Bronchoalveolar_lavage&oldid=1228524254"