Document Detail


Combined bronchoalveolar lavage and transbronchial lung biopsy: safety and yield in ventilated patients.
MedLine Citation:
PMID:  12662007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to evaluate the safety and diagnostic yield of bedside bronchoalveolar lavage (BAL) combined with fibrescopic transbronchial lung biopsy (TBLB) in determining the aetiology of pulmonary infiltrates in mechanically ventilated patients. The records of 38 mechanically ventilated patients who underwent BAL/TBLB to investigate unexplained pulmonary infiltrates were retrospectively reviewed. Patients were divided into two groups: immunocompetent (group 1: n = 22; group 1a: n = 11, late acute respiratory distress syndrome (ARDS); group 1b: n = 11, no ARDS) and immunocompromised (group 2, n=16). The procedure allowed a diagnosis in 28 patients (74%), inducing therapeutic modification in 24 (63%) and confirmation of clinical diagnosis in four (11%). In groups 1a, 1b and 2, diagnosis was obtained in 11 out of 11 (fibroproliferation), seven out of 11 and 10 out of 16 patients, and therapy changed in 11 out of 11 (administration of steroids), six out of 11 and seven out of 16 patients, respectively. Pneumothorax occurred in nine patients (four of group 1a), bleeding in four (<35 mL), and transient hypotension in two. No fatalities were procedure-related. Combined bronchoalveolar lavage/transbronchial lung biopsy is of diagnostic and therapeutic value in mechanically ventilated patients with unexplained pulmonary infiltrates, excluding those with late acute respiratory distress syndrome. Although complications are to be expected, the benefits of the procedure appear to exceed the risks in patients in whom a histological diagnosis is deemed necessary.
Authors:
P A Bulpa; A M Dive; L Mertens; M A Delos; J Jamart; P A Evrard; M R Gonzalez; E J Installé
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The European respiratory journal     Volume:  21     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-28     Completed Date:  2003-06-26     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  489-94     Citation Subset:  IM    
Affiliation:
Dept of Intensive Care, Mont-Godinne University Hospital, Université Catholique de Louvain, Yvoir, Belgium. pierre.bulpa@rean.ucl.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biopsy, Needle / methods*
Bronchoalveolar Lavage
Bronchoalveolar Lavage Fluid / cytology*
Bronchoscopy
Female
Humans
Immunocompetence
Immunocompromised Host
Male
Middle Aged
Pneumonia / diagnosis*
Respiration, Artificial / adverse effects,  methods*
Respiratory Distress Syndrome, Adult / therapy*
Retrospective Studies
Sensitivity and Specificity
Comments/Corrections
Comment In:
Eur Respir J. 2003 Mar;21(3):383-4   [PMID:  12661988 ]

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