Bronchoalveolar lavage

The bronchoalveolar lavage ( BAL; Latin: bronchus " bronchus " alveolus " alveoli " and lavare " washing") and technically it different bronchial lavage are diagnostic and therapeutic procedures in medicine. The latter is in English also - more historical - called tracheal wash ( " windpipe purge" ). These methods are used for removal of mucus, and the removal of mucus, and cytological samples from the lungs during a bronchoscopy.

Implementation

The bronchoalveolar lavage performed in the lung depth, the alveoli, and serves cytological and immunohistochemical studies.

The bronchoalveolar lavage is carried out, however, in the trachea and the bronchi, and helps in bacteriological tests, during mechanical cleaning or cytological studies. Often it is combined with brush smears in the extraction of cells, as well as with sampling using fine forceps.

There are combined forms, in which the therapeutic secretion removal flushing liquid in varying amounts, up to many liters, is used, for example, in alveolar proteinosis.

In humans, it is usually a Ringer's solution or 0.9% saline into the lungs and then sucks it off again. In the extracted solution are then flushed out with the mucus cells of the respiratory epithelium and immune system as well as any bacteria and other pathogens.

Examination of the material

The material thus obtained can be examined cytologically, for example, to diagnose lung cancer, or a bacteriological examination to determine the specific pathogen to be supplied. Further evidence of organ involvement in the context of autoimmune diseases can be made (eg, sarcoidosis, alveolitis or systemic scleroderma). Use specific cytological pattern of acquired immune cells (mostly leukocytes) are leading the way.

Risks

After BAL occurs in up to 2.3 % of cases, complications, however, are not serious. Thus, it may, after investigation fever, a narrowing of the bronchial tubes, a reversible ( reversible ) coming decline in lung function parameters or reversible inflammatory infiltrates of lung segments. In patients with an increased bleeding tendency and postoperative bleeding can occur.