VOOZH about

URL: https://link.springer.com/article/10.1007/BF01691489?error=cookies_not_supported&code=09bb86e3-98da-4ec7-a61f-bb31890d2aec

⇱ The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia | European Journal of Clinical Microbiology & Infectious Diseases | Springer Nature Link

Skip to main content

The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia

  • Review
  • Published:

Abstract

Bronchoalveolar lavage (BAL) has become an invaluable diagnostic tool with important clinical implications in both opportunistic infections and the pulmonary pathology of immunologic disease. Until recently, the use of BAL was limited primarily to two areas: the study of interstitial lung diseases and the diagnosis of lung infections by opportunistic microorganisms in severely immunocompromised patients with lung infiltrates. Over the past decade, the use of BAL has been expanded to include the conventional diagnosis of bacterial pneumonia in non-immunocompromised patients. In the past, different clinical studies proposed using BAL to quantify cultures in the sample obtained as a means of increasing the tool's effectiveness. Recent developments have led to a number of newer applications of BAL, such as bronchoscopic BAL, non-bronchoscopic BAL and protected BAL. The most important use of BAL in the non-immunocompromised patient is the diagnosis of pneumonia in the mechanically ventilated patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+
from $39.99 /Month
  • Starting from 10 chapters or articles per month
  • Access and download chapters and articles from more than 300k books and 2,500 journals
  • Cancel anytime
View plans

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Explore related subjects

Discover the latest articles, books and news in related subjects, suggested using machine learning.

References

  1. Jackson C: Bronchoscopy: past, present and future. New England Journal of Medicine 1928, 199: 759–763.

    Google Scholar 

  2. Stitt H: Bronchial lavage for disinfection and immunization of the bronchial tree. Journal of Medicine Cincinnati Academy 1934, 14: 576–579.

    Google Scholar 

  3. Carlens E: A new flexible double-lumen catheter for bronchospirometry. Journal of Thoracic Surgery 1949, 18: 742.

    Google Scholar 

  4. Métras H: Le cathériseme bronchique. In: Métras H, Charpin J (ed): Le cathérisme bronchique. Vigot-Frères, Paris, 1953, p. 55–65.

    Google Scholar 

  5. Harris JA, Swenson EW, Johnson JE: Human alveolar macrophages: comparison of phagocytic, glucose utilization, and ultrastructure in smokers and nonsmokers. Journal of Clinical Investigation 1970, 49: 2086–2096.

    PubMed  Google Scholar 

  6. Cohen AB, Cline MJ: The human alveolar macrophage: isolation, cultivation in vitro and studies of morphologic functional characteristics. Journal of Clinical Investigation 1971, 50: 1390–1398.

    PubMed  Google Scholar 

  7. Mann PEG, Cohen AB, Finley TN, Ladman AJ: Alveolar macrophages: structural and functional differences between nonsmokers and smokers of marijuana and tobacco. Laboratory Investigation 1971, 25: 111–120.

    PubMed  Google Scholar 

  8. Finley TN, Ladman AJ: Low yield of pulmonary surfactant in cigarette smokers. New England Journal of Medicine 1972, 286: 111–120.

    Google Scholar 

  9. Ramirez RJ, Kieffer RF Jr, Ball WC: Bronchopulmonary lavage in man. Annals of Internal Medicine 1965, 63: 819–828.

    PubMed  Google Scholar 

  10. Ikeda S, Yanai N, Ishikawa S: Flexible bronchofiberscope. Annals of Otology, Rhinology and Laryngology 1969, 79: 916–919.

    Google Scholar 

  11. Cantrell ET, Warr GA, Busbee DL, Martin RR: Induction of aryl hydrocarbon hydroxylase in human pulmonary alveolar macrophages by cigarette smoking. Journal of Clinical Investigation 1973, 52: 1881–1884.

    PubMed  Google Scholar 

  12. Reynolds HY, Newball HH: Analysis of proteins and respiratory cells obtained from human lungs by bronchial lavage. Journal of Laboratory and Clinical Medicine 1974, 84: 559–573.

    PubMed  Google Scholar 

  13. Daniele RP, Altose MD, Rowland DR Jr: Immunocompetent cells from the lower respiratory tract of normal human lungs. Journal of Clinical Investigation 1975, 59: 986–996.

    Google Scholar 

  14. Warr GA, Martin RR, Sharp PM, Rossen RD: Normal human bronchial immunoglobulin and proteins: effects of cigarette smoking. American Review of Respiratory Disease 1977, 116: 25–30.

    PubMed  Google Scholar 

  15. Low RB, Davis G, Giancola MS: Biochemical analyses of bronchoalveolar lavage fluids of normal healthy volunteers. American Review of Respiratory Disease 1978, 118: 803–875.

    Google Scholar 

  16. Lawrence EC, Blaese RM, Martin RR, Stevens PM: Immunoglobulin secreting cells in normal human bronchial lavage. Journal of Clinical Investigation 1978, 62: 832–835.

    PubMed  Google Scholar 

  17. Hunninghake GW, Gadek JE, Kawanani O, Ferrans VJ, Crystal RG: Inflammatory and immune processes in the human lung in health and disease: evaluation by bronchoalveolar lavage. American Journal of Pathology 1979, 97: 149–206.

    PubMed  Google Scholar 

  18. Merril WW, Goodenberger D, Strober W, Matthay RA, Naegel GP, Reynolds HY: Free secretory component and other proteins in human lung lavage. American Review of Respiratory Disease 1980, 12: 156–161.

    Google Scholar 

  19. Merril WW, Naegel GP, Reynolds HY: Reaginic antibody in the lung lining fluid: analysis of normal human bronchoalveolar lavage IgE and comparison to immunoglobulins G and A. Journal of Laboratory and Clinical Medicine 1980, 96: 494–500.

    PubMed  Google Scholar 

  20. Harlan P, Turton C, Heard B, Lukoszek A, Collins JU, Salsbury AJ, Turner-Warwick M: Bronchoalveolar lavage in pulmonary fibrosis: comparison of cells obtained with lung biopsy and clinical features. Thorax 1980, 35:9–18.

    PubMed  Google Scholar 

  21. Biserte G, Crétien J, Voisin C (ed): Le lavage broncho-alvéolaire chez l'homme-colloque. Institut National de la Santé et de la Recherche Médicale, Paris, 1979, p. 1–554.

    Google Scholar 

  22. Crystal RG, Reynolds HY, Kalica A: Summary of the proceedings of the 1984 International Conference on Bronchoalveolar Lavage. Chest 1986, 89: 122–131.

    Google Scholar 

  23. The BAL Cooperative Group Steering Committee: Bronchoalveolar constituents in healthy individuals, idiopathic pulmonary fibrosis, and selected comparison groups. American Review of Respiratory Disease 1990, 141: 169–202.

    Google Scholar 

  24. Meduri GV, Baselski V: The role of bronchoalveolar lavage in diagnosing non-opportunistic bacterial pneumonia. Chest 1991, 100: 179–190.

    PubMed  Google Scholar 

  25. Kelly CA, Kotre CJ, Ward C, Hendrick DJ, Walters EH: Anatomical distribution of bronchoalveolar lavage fluid as assessed by digital subtraction radiography. Thorax 1987, 42: 624–628.

    PubMed  Google Scholar 

  26. Meduri GU, Chastre J: The standarization of bronchoscopic techniques for ventilator-associated pneumonia. Chest 1992, 102: 557–564.

    Google Scholar 

  27. Reynolds HY: State of the art. Bronchoalveolar lavage. American Review of Respiratory Disease 1987, 135: 250–263.

    PubMed  Google Scholar 

  28. Stover DE, Zaman MB, Hajdu SI, Lange M, Gold J, Armstrong D: Bronchoalveolar lavage in the diagnosis of diffuse pulmonary infiltrates in the immunosuppressed. Annals of Internal Medicine 1984, 101: 1–7.

    PubMed  Google Scholar 

  29. Kelley J, Landis JN, Daris GS, Trainer TD, Jakab GJ, Green GM: Diagnosis of pneumonia due to pneumocystis by subsegmental pulmonary lavage via the fiberoptic bronchoscope. Chest 1978, 74: 24–28.

    PubMed  Google Scholar 

  30. Stover DE, White DA, Romano PA, Gellene RA: Diagnosis of pulmonary disease in acquired immune deficiency syndrome (AIDS). American Review of Respiratory Disease 1984, 130: 659–662.

    PubMed  Google Scholar 

  31. Bartlett JG, Alexander J, Mayhew J, Sullivan SN, Gobarch SH: Should fiberoptic bronchoscopy aspirates be cultured? American Review of Respiratory Disease 1976, 114: 73–78.

    PubMed  Google Scholar 

  32. Thorpe JE, Baughman RP, Frame PT, Wesseler TA, Staneck JL: Bronchoalveolar lavage for diagnosing acute bacterial pneumonia. Journal of Infectious Diseases 1987, 155: 855–861.

    PubMed  Google Scholar 

  33. Kahn F, Jones JM: Diagnosing bacterial respiratory infection by bronchoalveolar lavage. Journal of Infectious Diseases 1987, 155: 862–869.

    PubMed  Google Scholar 

  34. Kirkpatrick MB, Bass JB Jr: Quantitative bacterial cultures of bronchoalveolar lavage fluids and protected brush catheter specimens from normal subjects. American Review of Respiratory Disease 1989, 139:546–548.

    PubMed  Google Scholar 

  35. Wimberly N, Faling LJ, Bartlett JG: A fiberoptic bronchoscopy technique to obtain uncontaminated lower airway secretion for bacterial culture. American Review of Respiratory Disease 1979, 119: 337–343.

    PubMed  Google Scholar 

  36. Wimberly N, Bass JB Jr, Boyd BW, Kirkpatrick MB, Serio RA, Pollock HM: Use of a bronchoscopic protected brush for the diagnosis of pulmonary infections. Chest 1982, 81: 556–562.

    PubMed  Google Scholar 

  37. Higuchi JH, Coalson JJ, Johanson WG: Bacteriologic diagnosis of nosocomial pneumonia in primates. American Review of Respiratory Disease 1982, 125: 53–57.

    PubMed  Google Scholar 

  38. Chastre J, Viau F, Brun P, Pierre J, Dauge MC, Bouchama A, Akesbi A, Gibert C: Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patients. American Review of Respiratory Disease 1984, 130: 924–929.

    PubMed  Google Scholar 

  39. Villers D, Deriennic M, Raffi N, Germaud P, Baron D, Nicolas F, Courtieu AL: Reliability of the bronchoscopy protected catheter brush in intubated patients. Chest 1985, 88: 527–530.

    PubMed  Google Scholar 

  40. Lorch DG Jr, John JF, Tomlinson JR, Miller KS, Shahn SA: Protected transbronchial needle aspiration and protected specimen brush in the diagnosis of pneumonia. American Review of Respiratory Disease 1987, 136: 565–569.

    PubMed  Google Scholar 

  41. Fagon JY, Chastre J, Hance AJ, Guiguet M, Trouillet JL, Domart Y, Pierre J, Gibert C: Detection of nosocomial lung infections in ventilated patients. Use of protected specimen brush and quantitative culture techniques in 147 patients. American Review of Respiratory Disease 1988, 138: 110–116.

    PubMed  Google Scholar 

  42. Torres A, Puig de la Bellacasa J, Rodriguez Roisin R, Jimenez de Anta MT, Agusti Vidal A: Diagnostic value of telescoping plugged catheter in mechanically ventilated patients with bacterial pneumonia using the Metras catheter. American Review of Respiratory Disease 1988, 138: 117–120.

    PubMed  Google Scholar 

  43. Lambert RS, Vereen LE, George RB: Comparison of tracheal aspirates and protected brush catheter specimens for identifying pathogenic bacteria in mechanically ventilated patients. American Journal of the Medical Sciences 1989, 297: 377–382.

    PubMed  Google Scholar 

  44. Sanchez Nieto JM, Carrillo Alcaraz A, Pardo Talavera JC, Varela Morion MC, Lopez Yepes ML, Gomez Rubi JA, Ruiz Gomez J: Análisis de la información bacteriológica aportada mediante catéter telescopado de doble luz y oclusión distal en el diagnóstico de infiltrados pulmonares en pacientes bajo ventilacion mecánica. Revista Clinica Española 1989, 184: 65–68.

    Google Scholar 

  45. Cook DJ, Fitzgerald JM, Guyazt GM, Walters S: Evaluation of the protected brush catheter and bronchoalveolar lavage in the diagnosis of pneumonia. Journal of Intensive Care Medicine 1991, 6: 196–205.

    PubMed  Google Scholar 

  46. Torres A, Gonzalez J, Ferrer M: Evaluation of the available invasive and non-invasive techniques for diagnosing nosocomial pneumonias in mechanically ventilated patients. Intensive Care Medicine 1991, 17: 439–448.

    PubMed  Google Scholar 

  47. Pollock DG, Hawkins EL, Benner JR, Sparkman T, Bargs JB Jr: Diagnosis of bacterial pulmonary infections with quantitative protected catheter cultures obtained during bronchoscopy. Journal of Clinical Microbiology 1983, 17: 255–259.

    PubMed  Google Scholar 

  48. Xaubet A, Torres A, Marco F, Puig de la Bellacasa J, Faus R, Agusti-Vidal A: Pulmonary infiltrates in immunocompromised patients. Diagnostic value of telescoping plugged catheter and bronchoalveolar lavage. Chest 1989, 95: 130–135.

    PubMed  Google Scholar 

  49. Chastre J, Fagon JY, Domart Y, Gibert C: Diagnosis of nosocomial pneumonia in intensive care unit patients. European Journal of Clinical Microbiology & Infectious Diseases 1989, 8: 35–39.

    Google Scholar 

  50. Fagon JY, Chastre J, Domart Y, Trouillet JL, Pierre J, Darne C, Gibert C: Nosocomial pneumonia in patients receiving continuos mechanical ventilation. Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. American Review of Respiratory Disease 1989, 140: 306–310.

    PubMed  Google Scholar 

  51. Johanson WG Jr, Seidenfeld JJ, Gomez P, De los Santos R, Coalson JJ: Bacteriologic diagnosis of nosocomial pneumonia following prolonged mechanical ventilation. American Review of Respiratory Disease 1988, 137: 259–264.

    PubMed  Google Scholar 

  52. Chastre J, Fagon JY, Soler P, Bornet M, Domart Y, Trouillet JL, Gibert C, Hance AJ: Diagnosis of nosocomial pneumonia in intubated patients undergoing ventilation: comparison of the usefulness of bronchoalveolar lavage and the protected specimen brush. American Journal of Medicine 1988, 85: 499–506.

    PubMed  Google Scholar 

  53. Chastre J, Fagon JY, Soler P, Domart Y, Pierre J, Dombret MC, Gibert C, Hance AJ: Quantification of BAL cells containing intracellular bacteria rapidly identifies ventilated patients with nosocomial pneumonia. Chest 1989, 95, Supplement 2: 190–192.

    PubMed  Google Scholar 

  54. Torres A, Puig de la Bellacasa J, Xaubet A, Gonzalez J, Rodriguez-Roisin R, Jimenez MT, Agusti Vidal A: Diagnostic value of quantitative culture of bronchoalveolar lavage and telescoping plugged catheter in mechanically ventilated patients with bacterial pneumonia. American Review of Respiratory Disease 1989, 140: 306–310.

    PubMed  Google Scholar 

  55. Guerra F, Baughman RP: Use of bronchoalveolar lavage to diagnose bacterial pneumonia in mechanically ventilated patients. Critical Care Medicine 1990, 18: 169–173.

    PubMed  Google Scholar 

  56. Caughey G, Wong H, Gamsu G, Golden J: Nonbronchoscopic bronchoalveolar lavage for the diagnosis ofPneumocystis carinii pneumonia in the AIDS. Chest 1985, 88: 659–662.

    PubMed  Google Scholar 

  57. Mann JM, Altus CS, Weber CA, Smith PR, Muto R, Hevrich AE: Nonbronchoscopic lung lavage for diagnosis of opportunistic infection in AIDS. Chest 1987, 91: 319–322.

    PubMed  Google Scholar 

  58. Piperno D, Gaussorgues P, Bachmann P, Jabouley JM, Robert D: Diagnostic value of nonbronchoscopic bronchoalveolar lavage during mechanical ventilation. Chest 1988, 92: 223.

    Google Scholar 

  59. Gaussorgues P, Piperno D, Bachman P, Boyer F, Jean G, Gerad M, Leger P, Robert D: Comparison of nonbronchoscopic bronchoalveolar lavage to open lung biopsy for the bacteriologic diagnosis of pulmonary infections in mechanically ventilated patients. Intensive Care Medicine 1989, 15: 94–98.

    PubMed  Google Scholar 

  60. Pugin J, Auckenthaler R, Mili N, Janssens JP, Lew PD, Suter PM: Diagnosis of ventilator associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic “blind” bronchoalveolar lavage fluid. American Review of Respiratory Disease 1991, 143: 1121–1129.

    PubMed  Google Scholar 

  61. Rouby JJ, Martin de Lassale E, Poete P, Nicolas M-H, Bodin L, Jarlier V, Le Charpentier YL, Grasset J, Viars P: Nosocomial bronchopneumonia in the critically ill. Histologic and bacteriologic aspects. American Review of Respiratory Disease 1993, 146: 1059–1066.

    Google Scholar 

  62. Rouby JJ, Rossignon MD, Nicolas MH, Martin de Lassale E, Cristin S, Grosset J, Viars P: A prospective study of protected bronchoalveolar lavage in the diagnosis of nosocomial pneumonia. Anesthesiology 1989, 71: 679–685.

    PubMed  Google Scholar 

  63. Meduri GU, Beals DH, Maijub AG, Baselski V: Protected bronchoalveolar lavage. A new bronchoscopic technique to retrieve uncontaminated distal airway secretions. American Review of Respiratory Disease 1991, 143: 855–864.

    PubMed  Google Scholar 

  64. Castella J, Ausina V, Puzo C, Quintana E, Rodriguez-Frojan G, Rello J, Lunquin M, Garcia-Pachon E, Belda P, Garcia Barcelo M: Lavado broncoalveolar protegido: nuevo método endoscópico en el diagnóstico de las neumonfas bacterianas. Medicina Clinica 1991, 96:721–726.

    PubMed  Google Scholar 

  65. Sanchez Nieto JM, Seller Perez G, Carrillo Alcaraz A, Ruiz Gomez J, Sola Perez J, Egea Caparros JM, Jara Perez P, Bru Cartagena M, Garcia Paredes T, Gomez Rubí JA: Estudio comparativo del lavado alveolar protegido frente al catéter telescópico ocluido en pacientes con sospecha de neumonia y en ventilación mecánica. Medicina Clinica 1993, 100: 1–4.

    Google Scholar 

  66. Berger R, Arangol L: Etiologic diagnosis of bacterial nosocomial pneumonia in seriously ill patients. Critical Care Medicine 1985, 13: 833–836.

    PubMed  Google Scholar 

  67. Marquette CH, Georges H, Wallet F, Ramon P, Saulnier F, Neviere R, Mathieu D, Rime A, Tonnel AB: Diagnostic efficiency of endotracheal aspirates with quantitative bacterial cultures in intubated patients with suspected pneumonia. Comparison with the protected specimen brush. American Review of Respiratory Disease 1993, 148: 138–144.

    PubMed  Google Scholar 

  68. Torres A, El-Ebiary M, Padro L, Gonzalez J, Puig de la Bellacasa J, Ramirez J, Xaubert A, Ferrer M, Rodriguez-Roisin R: Validation of different techniques for the diagnosis of ventilator-associated pneumonia. Comparison with immediate postmortem pulmonary biopsy. American Review of Respiratory Disease 1994, 149: 324–331.

    Google Scholar 

  69. Zavala DC, Schoell JE: Ultrathin needle aspiration of the lung in infections and malignant disease. American Review of Respiratory Disease 1980, 123: 125–131.

    Google Scholar 

  70. Dorca J, Manresa F, Esteban LL, Barreiro B, Prats E, Ariza J, Verdaguer R, Gudiol F: Efficacy, safety, and therapeutic relevance of transthoracic aspiration with ultrathin needle in nonventilated nosocomial pneumonia. American Journal of Respiratory and Critical Care Medicine 1995, 151: 1491–1496.

    PubMed  Google Scholar 

  71. Dorca J: Técnicas invasivas en el diagnóstico de las neumonías. Archivos de Bronconeumologia 1989, 25: 270–281.

    Google Scholar 

  72. Torres A, Jimenez P, Puig de la Bellacasa J, Celis R, Gonzalez J, Gea J: Diagnostic value of nonfluoroscopic percutaneous lung needle aspiration in patients with pneumonia. Chest 1990, 98: 840–844.

    PubMed  Google Scholar 

  73. Faling LJ: New advances in diagnosing nosocomial pneumonia in intubated patients. American Review of Respiratory Disease 1988, 137: 253–255.

    PubMed  Google Scholar 

  74. Chastre J, Fagon JY, Lamer CH: Procedures for the diagnosis of pneumonia in ICU patients. Intensive Care Medicine 1992, 18, Supplement 1: 10–17.

    Google Scholar 

  75. Bartlett JG, Finegold SM: Bacteriology of expectorated sputum with quantitative culture and wash technique compared to transtracheal aspirates. American Review of Respiratory Disease 1978, 117: 1019–1027.

    PubMed  Google Scholar 

  76. Bartlett J: Diagnostic accuracy of transtracheal aspiration bacteriologic studies. American Review of Respiratory Disease 1977, 115: 777–782.

    PubMed  Google Scholar 

  77. Rankin JA: Role of bronchoalveolar lavage in the diagnosis of pneumonia. Chest 1989, 95, Supplement 2: 187–190.

    Google Scholar 

  78. Berger R, McConnell JW, Phillips B, Overman TL: Safety and efficacy of using high-dose topical and nebulized anesthesia to obtain endobronchial cultures. Chest 1989, 95: 299–303.

    PubMed  Google Scholar 

  79. Dotson RG, Pinglenton SK: The effect of antibiotic therapy on recovery of intracellular bacteria from bronchoalveolar lavage in suspected ventilator-associated nosocomial pneumonia. Chest 1993, 103: 541–546.

    PubMed  Google Scholar 

  80. Meduri GU, Belenchia JM, Estes RJ, Wunderink RG, El Torky M, Leeper KV: Fibroproliferative phase of ARDS. Clinical findings and effects of corticosteroids. Chest 1991, 100: 943–952.

    PubMed  Google Scholar 

  81. Salata RA, Lederman MM, Sheles DM, Jacobs MR, Eckstein E, Tweardy D, Toors Z, Chmielewski R, Marino J, King CH, Graham RC, Ellner JJ: Diagnosis of nosocomial pneumonia in intubated intensive care unit patients. American Review of Respiratory Disease 1987, 135: 426–432.

    PubMed  Google Scholar 

  82. Shepherd K, Lynch K, Wilson R, Zapol W: Diagnosis of pneumonia in patients with adult respiratory distress syndrome. Chest 1988, 98: 459.

    Google Scholar 

  83. Niederman MS, Torres A, Summer W: Invasive diagnostic testing is not needed routinely to manage suspected ventilator-associated pneumonia. American Journal of Respiratory and Critical Care Medicine 1994, 150: 565–569.

    PubMed  Google Scholar 

  84. Chastre J, Fagon JY: Invasive diagnostic testing should be routinely used to manage ventilated patients with suspected pneumonia. American Journal of Respiratory and Critical Care Medicine 1994, 150: 570–574.

    PubMed  Google Scholar 

  85. Dreyfuss D, Mier L, Le Bourdelles G, Djedaini K, Brun P, Boussougant Y, Coste F: Clinical significance of borderline quantitative protected brush specimen culture results. American Review of Respiratory Disease 1993, 147: 941–951.

    Google Scholar 

  86. Torres A, Martos A, Puig de la Bellacasa J, Ferrer M, El-Ebiary M, Gonzalez J, Gene A, Rodriguez-Roisin R: Specificity of endotracheal aspiration, protected specimen brush and bronchoalveolar lavage in mechanically ventilated patients. American Review of Respiratory Disease 1993, 147: 952–957.

    PubMed  Google Scholar 

  87. Rodriguez de Castro F, Sole J, Elcuaz R: Quantitative cultures of protected brush specimens and bronchoalveolar lavage in ventilated patients without suspected pneumonia. American Journal of Respiratory and Critical Care Medicine 1994, 149: 320–323.

    PubMed  Google Scholar 

  88. Krueger JJ, Sayre VA, Karetzky MS: Bronchoalveolar lavage induced pneumothorax. Chest 1988, 94: 440–441.

    PubMed  Google Scholar 

  89. Shrader DL, Lakshminarayan S: The effect of fiberoptic bronchoscopy on cardiac rhythm. Chest 1978, 73: 821–824.

    PubMed  Google Scholar 

  90. Luck JC, Messeder OH, Rubenstein MJ, Morrissey W, Engel TR: Arrhythmias from fiberoptic bronchoscopy. Chest 1978, 74: 139–143.

    PubMed  Google Scholar 

  91. Albertini RE, Harrell JH, Moser KM: Management of arterial hypoxemia induced by fiberoptic bronchoscopy. Chest 1975, 67: 134–136.

    PubMed  Google Scholar 

  92. Dubrawsky C, Awe RJ, Jenkins DE: The effect of bronchofiberoptic examination on oxygenation status. Chest 1975, 67: 137–140.

    PubMed  Google Scholar 

  93. Pugin J, Suter PM: Diagnostic bronchoalveolar lavage in patients with pneumonia produces sepsis like systemic effects. Intensive Care Medicine 1992, 18: 6–10.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Secciòn de Neumologia, Hospital Morales Meseguer, Murcia, Spain

    J. M. Sanchez Nieto

  2. Secciòn de Medicina Intensiva, Hospital General Universitario, Av. Intendente Palacios, no. 3, Murcia, Spain

    A. Carillo Alcaraz

Authors
  1. J. M. Sanchez Nieto
  2. A. Carillo Alcaraz

About this article

Cite this article

Nieto, J.M.S., Alcaraz, A.C. The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 14, 839–850 (1995). https://doi.org/10.1007/BF01691489

Download citation

  • Issue date:

  • DOI: https://doi.org/10.1007/BF01691489

Keywords