ICU learning pathway | Bronchial_lavage

Bronchoalveolar Lavage
Session Overview
Description
This session describes bronchoalveolar lavage. It also reviews the indications, the procedure, the investigations that are performed and the complications that can arise.

By the end of this session you will be able to:

• List the common indications for bronchoalveolar lavage (BAL)
• Describe the preparation of the patient and equipment for BAL
• Describe how to perform a BAL
• List the common investigations that are performed
• Identify the common complications of performing a BAL

Before commencing this session you should complete:

• Trachea, Main Bronchi, Broncho-Pulmonary Segments (001-0557)
• Management of Sedation on ICU (001-0271)

Bronchoalveolar lavage (BAL), performed during a flexible bronchoscopy or using a blind technique, has become a widely accepted, minimally-invasive procedure.

It can provide important information about immunologic, inflammatory and infectious processes at the alveolar level.

Flexible bronchoscopy has the advantage of being able to visualize the respiratory tree to the third generation of branching, while also being able to biopsy bronchial lesions. Bronchoscopically obtained biopsies have been shown to be similar, in terms of cell type and state of activation, to open lung biopsies, but much less invasive.

Performing BAL can be diagnostic in its own right and can also be used to differentiate between several differential diagnoses suggested by thoracic imaging. Therefore, being able to appropriately perform and interpret a BAL and the subsequent results can aid in the treatment of the critically-ill patient.