Efficacy Of Bronchoalveolar Lavage Research Articles

Efficacy of synthetic surfactant (CHF5633) bolus and/or lavage in meconium-induced lung injury in ventilated newborn rabbits.

The pathogenesis of neonatal meconium aspiration syndrome (MAS) involves meconium-induced lung inflammation and surfactant inactivation. Bronchoalveolar lavage (BAL) with diluted surfactant facilitates the removal of meconium. CHF5633, one of the most promising synthetic surfactants, is effective in neonatal respiratory distress syndrome. Here we investigated its efficacy via BAL in an experimental MAS model. Experimental MAS was induced at birth in near-term newborn rabbits by intratracheal instillation of reconstituted human meconium. First, undiluted CHF5633 was compared with a porcine-derived surfactant (Poractant alfa) via intratracheal bolus (200 mg/kg). Second, the efficacy of BAL with diluted CHF5633 (5 mg/mL, 20 ml/kg) alone, or followed by undiluted boluses (100 or 300 mg/kg), was investigated. Meconium instillation caused severe lung injury, reduced endogenous surfactant pool, and poor survival. CHF5633 had similar benefits in improving survival and alleviating lung injury as Poractant alfa. CHF5633 BAL plus higher boluses exerted better effects than BAL or bolus alone in lung injury alleviation by reversing phospholipid pools and mitigating proinflammatory cytokine mRNA expression, without fluid retention and function deterioration. CHF5633 improved survival and alleviated meconium-induced lung injury, the same as Poractant alfa. CHF5633 BAL plus boluses was the optimal modality, which warrants further clinical investigation. To explore the efficacy of a synthetic surfactant, CHF5633, in neonatal lung protection comparing with Poractant alfa in a near-term newborn rabbit model with meconium-induced lung injury. Similar effects on improving survival and alleviating lung injury were found between CHF5633 and Poractant alfa. Optimal therapeutic effects were identified from the diluted CHF5633 bronchoalveolar lavage followed by its undiluted bolus instillation compared to the lavage or bolus alone regimens. Animals with CHF5633 lavage plus bolus regimen exerted neither substantial lung fluid retention nor lung mechanics deterioration but a trend of higher pulmonary surfactant-associated phospholipid pools.

Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: a comparative study

BackgroundAdenovirus pneumonia is prone to severe clinical and imaging manifestations in children. Bronchoscopic alveolar lavage (BAL) is an important adjunctive therapy for patients with severe imaging findings. The study aimed to evaluate the effect of the timing on the efficacy of bronchoalveolar lavage in children with adenovirus pneumonia.MethodsThis study included 134 patients with adenovirus pneumonia treated with BAL at Guangzhou Women and Children's Medical Center from January 2019 to January 2020.They were classified into the severe and mild groups. Based on the timing of BAL, each group was divided into the early BAL layer (received BAL within 1–9 days of the illness course) and the late BAL layer (received BAL within 10–14 days of the illness course). The clinical data of patients with different BAL timings were analyzed in two groups.ResultsAmong the 134 patients, 70 were categorized into the mild group and 64 were categorized into the severe group. Of the 134 patients, 42 patients received BAL early (mild group: n = 21 and severe group: n = 21) and 92 patients received BAL later (mild group: n = 49 and severe group: n = 43). In the mild group, the fever and hospital duration were shorter in patients who received BAL early than in those who received BAL later (p < 0.05). However, in the severe group, there were no statistically significant differences in the fever and hospital duration between patients who received BAL early and those who received BAL later. However, the need for mechanical ventilation and the incidence of BAL complications, such as new need for oxygen, were higher in patients who received BAL early than in those who received BAL later in the severe group (p < 0.05).ConclusionFor mild adenovirus pneumonia, early BAL may shorten the fever and hospital duration. However, early BAL in severe cases might not shorten the course of the disease or improve prognosis and may even increase the risks of mechanical ventilation and BAL complications.

Comparison of the Patient Diagnostic Yield of Fibre-optic Bronchoscopy with Conventional Tracheal Aspirate

Objective: To know the efficacy of Bronchoalveolar Lavage (BAL) in establishing diagnosis and its impact on overall health status of the patients.&#x0D; Methods: A single center, longitudinal study involving 40 patients aged &gt; 18 years old with septic shock with similar baseline characteristics was conducted. Two study arms, 20 patients in intervention arm - patient with utilization of Bronchoscopy and BAL in aiding diagnosis and 20-patients in conservative- arm without Bronchoscopy were compared in terms of establishing diagnosis primarily and secondarily in terms of length of stay and 30-day mortality. We were able to identify following organisms in BAL sample: Mycobacterium tuberculosis- 4, Acinetobacter baumanii- 3, Pseudomonasaeruginosa- 2, Klebsiella oxytica- 2, E. coli- 2, Streptococcus pneumoniae- 2, Staphyloccus aureus-&#x0D; Results: We were able to identify various infectious agents as mentioned above 16/20 in BAL group compared to 8/20 in conventional arm; neoplasm in 4 out of 20 subjects in BAL group. In 80% of cases, BAL helped in identifying the organisms compared to only 40% in tracheal aspirate group. In addition, six cases in Intervention arm vs. nine cases in conventional arm had more than &gt; 14 days hospital stay with the p-value 0 .492091. Interventional arm had lesser mortality 5 cases vs. 7 cases in Conventional arm with the p-value of 0.490153 which was not statistically significant.&#x0D; Conclusion: We conclude that the diagnostic bronchoscope and related procedures among critically ill patients are helpful in identifying the pathogens and in detecting malignancy.

Efficacy of Bronchoalveolar Lavage as Adjunct Therapy in the Treatment of Neonatal Severe Pneumonia: A Prospective Case-Control Study.

The aim of this study was to investigate the efficacy and safety of bronchoalveolar lavage (BAL) in the treatment of neonatal severe pneumonia (NSP). One hundred patients with severe pneumonia were randomly divided into two groups, the BAL and control groups, with 50 patients in each group. In the BAL group, normal saline was instilled into the endotracheal tube for BAL. Before and after lavage, lung ultrasound (LUS) monitoring was performed to observe the lung pathological changes. Conventional treatment was administered in the control group. The need for and duration of invasive mechanical ventilation, the complication rate, the duration and cost of hospitalization and the mortality rate were compared between the two groups. The results of this study showed that there were 35 (70%) patients who meet the indications of the invasive mechanical ventilation (IMV) at admission in the BAL group, while there were only 15 (30%) patients still requiring IMV after BAL therapy. The duration of IMV was 41.7 ± 7.5 vs. 97.7 ± 12.9 h in BAL and controls, the incidence rate of complications was 8.0% vs. 20.0% in both groups, the length of hospital stay was 9.2 ± 1.9 vs. 14.1 ± 2.1 days in both groups, and the expense of hospital cost was 12557 ± 832 vs. 19121 ± 929 Chinese Yuan in both groups. All patients had stable vital signs during lavage, and no significant adverse side effects were observed. BAL was significantly beneficial for NSP with no significant adverse side effects; LUS is a useful tool for the timely detection of BAL effects.

BAL が診断, 治療効果判定に有効であった気管支拡張症に合併した肺ノカルジア症の 1 例

BAL が診断, 治療効果判定に有効であった気管支拡張症に合併した肺ノカルジア症の 1 例

Evaluation of Bronchoalveolar Lavage Cytology (B.A.L) in the Diagnosis of Lung Cancer among Sudanese Patients in Khartoum State Hospitals

Introduction: Lung cancer is the most common cause of cancer mortality worldwide, causing approximately 1.2 million deaths per year. Bronchoalveolar Lavage (BAL) is a minimally invasive procedure that has gained acceptance and steady popularity as a tool for diagnosing lung cancer. The aim of this study was to compare the diagnostic efficacy of BAL in diagnosing lung cancer, taking bronchial biopsy as the ‘Gold Standard’ diagnostic test. Material and Methods: During the period from 2010 to 2012, 179 BAL cytology samples were prepared for cytology examination and smears were stained with Diff Quick stain. Bronchial biopsy histological sections were stained with H&E stain. Histo/Cytology correlation was performed in 83 cases to determine the sensitivity and specificity of BAL in diagnosis of lung carcinoma. Results: Out of the 179 cases, 118 (65.9%) were males and 61 (34.1%) were females. The ages ranged from 18 to 86 years old. BAL cytology cases reported with diagnoses of negative for malignant cells (nZ152, 84.9%), suspicious (nZ12, 6.7%), and carcinoma (nZ15, 8.4%). Bronchial biopsy specimens showed benign and malignant conditions in 69 (76.6%), and 21 (23.4%) respectively. Of the 21 malignant conditions, 11 were squamous cell carcinoma, 9 were adenocarcinoma, and one case was small cell carcinoma. The correlation between BAL cytology and histology results were performed in 83 cases. BAL sensitivity and specificity was 55%, and 95% respectively. Conclusion: Bronchoalveolar Lavage (BAL) is an easily performed, noninvasive, and well tolerated procedure that is useful in routine assessment of patients for lung carcinoma. The low sensitivity of BAL in our study stresses the importance of optimum sampling as well as cytopreperatory techniques using cyto-centrifugation. BAL combined to bronchial biopsy increases the accuracy of lung carcinoma diagnosis.

Efficacy of broncho-alveolar lavage and bronchial brush cytology in diagnosing lung cancers

Of all the cases investigated for suspected lung cancer between June 1999 and June 2003, 196 cases were selected where flexible bronchoscopic samples of broncho-alveolar lavage (BAL) and bronchial brush (BB) cytology as well as bronchial biopsy were taken and processed as per standard procedures of cytology and histology. The aim of this study was to compare the diagnostic efficacy of BAL and BB cytology in diagnosing lung cancer, taking bronchial biopsy as the 'Gold Standard' diagnostic test. Sensitivity of BB was 87.3%; while that of BAL was 39.4%. Specificity of BB and BAL was 97.6% and 89.6%, respectively. BB was better than BAL in morphological typing of lung cancers. We conclude that bronchial brushing is a much superior technique in the diagnosis and morphological typing of lung cancers.

The efficacy of bronchoalveolar lavage in the diagnosis of pulmonary tuberculosis

In order to analyze the usefulness of bronchoalveolar lavage (BAL) for conventional microbiological diagnosis of tuberculosis (TB) and other mycobacteria, and to assess the need to use it or not as a routine diagnostic technique in these diseases, we studied 30 patients with mycobacteria (26 TB and 4 Mycobacterium avium-intracellulare infections) by bronchoscopy, with BAL and bronchoaspirate (BAS) bacteriological analyses also available. The results were compared with those obtained for sputum taken before and after bronchoscopy when these specimens were available. The overall yield for BAL and BAS cultures was 90%, with BAL (83.3%) specimens being more productive than BAS (73.3%) specimens. Both performed far better than the 53.8% recorded for cultures of pre-bronchoscopy sputum and 60% for post-bronchoscopy sputum. BAL was the only diagnostic specimen from 7 patients, while BAS the only one from 4. Sensitivity was similar for the two mycobacteria studied. The results for direct bacilloscopy, however, at 30% for the two specimens, rose to 36.6% when they were analyzed together with BAS and BAL. We conclude that bronchoscopy should be performed on all patients suspected of mycobacterial infection when sputum bacilloscopy is negative and patients have no expectoration. Performance of BAL should be routine since this simple and usually uncomplicated technique produces the most productive specimens.