110:
297:, and suction tubing. Essentially, the saline source is connected to sterile bronchoscope, as is the specimen collection trap, and then suction tubing is connected to the trap and the suction source. If the bronchoscope is not sterile, saline should initially be used to flush it clean. With the patient under some sort of anesthesia (depending on the rigidity of the scope), the fiber-optic cable is lowered into the correct area of the lower lungs (
301:), wedged into place, and saline applied. Once the saline is fully applied, then either suction is applied to collect the fluids, or the fluids are collected with a sterile syringe through the irrigation channel. The collection trap is then appropriately labeled and sent off for testing.
304:
Recent literature for the use of endoscopic BAL in therapy uses essentially the same process. A flexible bronchoscope is most commonly used. The physician seeks out areas with excess mucus or other abnormalities, then uses saline and suction to clean it.
1163:
Wang, Lijun; Xie, Qiuling; Xu, Shanshan; Li, Huajun; Zhang, Liya; Ai, Jingwen; Liu, Quanhua; Chu, Caiting; Zhang, Xi; Zhang, Wenhong; Huang, Lisu (January 2023). "The role of flexible bronchoscopy in children with
Mycoplasma pneumoniae pneumonia".
230:
can be a more sensitive method of detection than nasal swabs in respiratory molecular diagnostics, as has been the case with SARS-CoV-2 where bronchoalveolar lavage samples detect copies of viral RNA after negative nasal swab testing.
111:
793:"Therapeutic limited bronchoalveolar lavage with fiberoptic bronchoscopy as a bridging procedure prior to total lung lavage in a patient with pulmonary alveolar proteinosis: A case report"
577:"High-throughput sequencing of 16S rDNA amplicons characterizes bacterial composition in bronchoalveolar lavage fluid in patients with ventilator-associated pneumonia"
1084:
689:"An official American Thoracic Society clinical practice guideline: The clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease"
1225:
154:
1218:
999:"Optimization strategy for the early timing of bronchoalveolar lavage treatment for children with severe mycoplasma pneumoniae pneumonia"
688:
662:"Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19)"
1839:
1211:
324:
262:
1092:
1575:
950:"Analysis of curative effect of adjuvant therapy with bronchoalveolar lavage on COPD patients complicated with pneumonia"
247:
206:, with a measured amount of fluid introduced and then collected for examination. This method is typically performed to
739:"Detection of SARS-CoV-2 by bronchoalveolar lavage after negative nasopharyngeal testing: Stay vigilant for COVID-19"
455:
417:
117:
285:
The primary equipment used in BAL includes a fiber-optic bronchoscope, sterile collection traps for collecting test
661:
1834:
628:"Laboratory testing for coronavirus disease (COVID-19) in suspected human cases: Interim guidance, 19 March 2020"
239:
1353:
274:
1769:
1744:
298:
1739:
1385:
997:
Wu, X; Lu, W; Wang, T; Xiao, A; Guo, X; Xu, Y; Li, S; Liu, X; Zeng, H; He, S; Zhang, X (5 October 2023).
525:"Bilateral versus unilateral bronchoalveolar lavage for the diagnosis of ventilator-associated pneumonia"
1203:
369:
Kahn, F.W.; Jones, J.M. (1987). "Diagnosing bacterial respiratory infection by bronchoalveolar lavage".
1729:
1585:
1580:
896:"Lung fluid biomarkers for acute respiratory distress syndrome: A systematic review and meta-analysis"
1447:
223:
1809:
1636:
1603:
1595:
161:
1048:
Michaud, G.; Reddy, C.; Ernst, A. (2009). "Whole-lung lavage for pulmonary alveolar proteinosis".
1363:
1252:
251:
1799:
1764:
1734:
1570:
734:
243:
1779:
1442:
443:
405:
234:
In particular, bronchoalveolar lavage is commonly used to diagnose infections in people with
277:(PAP). When conditions disallow WLL, an endoscopic BAL can be used as a bridging procedure.
1651:
1626:
1437:
266:
8:
1774:
1756:
1724:
1674:
1299:
286:
1025:
998:
1646:
1618:
1472:
1372:
1235:
1189:
1145:
974:
949:
922:
895:
868:
843:
819:
792:
765:
738:
603:
576:
549:
524:
497:
472:
294:
1804:
1794:
1307:
1193:
1181:
1137:
1065:
1030:
979:
927:
873:
824:
770:
711:
608:
554:
502:
451:
413:
386:
290:
270:
235:
207:
149:
261:), improve airway ventilation, and reduce airway inflammation in conditions such as
1173:
1149:
1127:
1057:
1020:
1010:
969:
961:
917:
907:
863:
855:
814:
804:
760:
750:
703:
635:
598:
588:
544:
536:
492:
484:
378:
32:
1557:
1529:
1432:
1132:
1115:
730:
167:
627:
1716:
1695:
1679:
1536:
1485:
1380:
1294:
1177:
1015:
755:
707:
382:
344:
912:
809:
1828:
1565:
1493:
1457:
1422:
1113:
473:"The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia"
1661:
1503:
1406:
1336:
1331:
1185:
1069:
1034:
983:
931:
828:
774:
715:
612:
558:
339:
269:. A much more intense version involving up to 50 liters of fluid is called
199:
1141:
1061:
965:
877:
659:
522:
506:
390:
1641:
1521:
1508:
1498:
1466:
1390:
1341:
1279:
1274:
1269:
1233:
859:
540:
334:
254:(ELF) and to determine the protein composition of the pulmonary airways.
729:
Ramos KJ, Kapnadak SG, Collins BF, Wall R, Bryson-Cahn C, Perchetti GA,
639:
593:
1631:
1513:
1414:
1315:
1289:
1284:
1261:
488:
314:
790:
202:
is passed through the mouth or nose into an appropriate airway in the
177:
1789:
1427:
1346:
349:
215:
211:
523:
Jonker, M.A.; Sauerhammer, T.M.; Faucher, L.D.; et al. (2012).
198:, is a diagnostic method of the lower respiratory system in which a
1398:
329:
219:
686:
1608:
1243:
477:
European
Journal of Clinical Microbiology and Infectious Diseases
1784:
1481:
1461:
1323:
319:
258:
227:
222:), though it also has been shown to have utility in diagnosing
574:
100:
80:
1047:
97:
1114:
Danel, C.; Israël-Biet, D.; Costabel, U.; Klech, H. (1992).
687:
Meyer, K.C.; Raghu, G.; Baughman, R.P.; et al. (2012).
660:
Centers for
Disease Control and Prevention (25 March 2020).
947:
203:
88:
74:
68:
53:
47:
696:
American
Journal of Respiratory and Critical Care Medicine
470:
44:
893:
625:
403:
59:
728:
575:
Yang, X.J.; Wang, Y.B.; Zhou, Z.W.; et al. (2015).
437:
435:
433:
431:
429:
257:
BAL has even been used therapeutically to remove mucus (
250:(ARDS). It is the most common method used to sample the
441:
426:
397:
368:
118:
56:
50:
35:
1116:"Therapeutic applications of bronchoalveolar lavage"
94:
85:
77:
65:
62:
41:
38:
948:Zhao, H.; Gu, H.; Liu, T.; Ge, J.; Shi, G. (2018).
894:Wang, Y.; Wang, H.; Zhang, C.; et al. (2019).
791:Rodrigo, D.; Rathnapala, A.; Senaratne, W. (2015).
518:
516:
91:
71:
889:
887:
786:
784:
16:Diagnostic method of the lower respiratory system
1826:
1082:
835:
513:
884:
841:
1041:
781:
1715:
1219:
943:
941:
464:
1107:
1085:"How 'Lung Washing' Helps You Breathe Again"
996:
990:
668:. Centers for Disease Control and Prevention
570:
568:
406:"6. Bronchoscopy in the Intensive Care Unit"
1162:
1076:
680:
653:
626:World Health Organization (19 March 2020).
619:
1226:
1212:
938:
280:
1131:
1024:
1014:
973:
921:
911:
867:
818:
808:
764:
754:
602:
592:
565:
548:
496:
362:
446:. In Demetriades, D.; Inaba, K. (eds.).
408:. In Demetriades, D.; Inaba, K. (eds.).
214:of the lower respiratory airways (e.g.
1827:
1207:
954:Experimental and Therapeutic Medicine
471:Nieto, J.M.S.; Alcaraz, A.C. (1995).
325:Chronic obstructive pulmonary disease
263:chronic obstructive pulmonary disease
581:Drug Design, Development and Therapy
404:Sugeir, S.; de Moraes, A.G. (2019).
1576:High-resolution computed tomography
1234:Tests and procedures involving the
666:Coronavirus Disease 2019 (COVID-19)
248:acute respiratory distress syndrome
13:
1083:Cleveland Clinic (6 August 2014).
14:
1851:
743:Respiratory Medicine Case Reports
733:, Khot S, Limaye AP, Mathias PC,
448:Atlas of Critical Care Procedures
410:Atlas of Critical Care Procedures
848:Archives of Disease in Childhood
442:Warriner, Z.; Lewis, M. (2019).
31:
1156:
797:Journal of Medical Case Reports
722:
1354:Laryngotracheal reconstruction
632:WHO/COVID-19/Laboratory/2020.5
371:Journal of Infectious Diseases
275:pulmonary alveolar proteinosis
1:
1840:Respiratory system procedures
1745:Positive pressure ventilation
634:. World Health Organization.
355:
1740:Negative pressure ventilator
1133:10.1183/09031936.93.05101173
1120:European Respiratory Journal
450:. Springer. pp. 57–62.
7:
444:"7. Bronchoalveolar Lavage"
308:
273:(WLL) and is used to treat
10:
1856:
1730:Surgical airway management
1586:Ventilation/perfusion scan
1386:Tracheoesophageal puncture
1178:10.1038/s41390-021-01874-z
1016:10.1186/s12879-023-08619-9
756:10.1016/j.rmcr.2020.101120
708:10.1164/rccm.201202-0320ST
1755:
1708:
1688:
1660:
1617:
1594:
1556:
1549:
1456:
1362:
1251:
1242:
913:10.1186/s13054-019-2336-6
810:10.1186/s13256-015-0574-z
224:interstitial lung disease
174:
160:
148:
140:
26:
21:
1810:Pulmonary rehabilitation
1637:Bronchial challenge test
1604:Pneumonia severity index
1596:Clinical prediction rule
844:"Bronchoalveolar lavage"
842:Henderson, A.J. (1994).
412:. Springer. p. 50.
383:10.1093/infdis/155.5.862
1003:BMC Infectious Diseases
281:Equipment and procedure
252:epithelial lining fluid
196:bronchoalveolar washing
144:Bronchoalveolar washing
1835:Diagnostic pulmonology
1800:Hyperinflation therapy
1765:Artificial respiration
1735:Mechanical ventilation
1670:Bronchoalveolar lavage
1571:CT pulmonary angiogram
236:immune system problems
188:Bronchoalveolar lavage
22:Bronchoalveolar lavage
1780:Decompression chamber
1448:Heart–lung transplant
1062:10.1378/chest.09-2295
966:10.3892/etm.2018.6662
299:tracheobronchial tree
265:(COPD) and pediatric
1652:Impulse oscillometry
1627:Body plethysmography
860:10.1136/adc.70.3.167
541:10.1089/sur.2011.081
267:Mycoplasma pneumonia
1775:Hyperbaric medicine
1757:Respiratory therapy
1675:Nasopharyngeal swab
1300:Acoustic rhinometry
594:10.2147/DDDT.S87634
529:Surgical Infections
1647:Diffusion capacity
1619:Lung function test
1236:respiratory system
1166:Pediatric Research
489:10.1007/BF01691489
226:. Bronchoalveolar
1822:
1821:
1818:
1817:
1805:Pulmonary hygiene
1795:Postural drainage
1704:
1703:
1545:
1544:
1095:on 14 August 2020
271:whole lung lavage
194:), also known as
185:
184:
1847:
1713:
1712:
1709:Other procedures
1554:
1553:
1249:
1248:
1228:
1221:
1214:
1205:
1204:
1198:
1197:
1160:
1154:
1153:
1135:
1111:
1105:
1104:
1102:
1100:
1091:. Archived from
1089:HealthEssentials
1080:
1074:
1073:
1056:(6): 1678–1681.
1045:
1039:
1038:
1028:
1018:
994:
988:
987:
977:
960:(5): 3799–3804.
945:
936:
935:
925:
915:
891:
882:
881:
871:
839:
833:
832:
822:
812:
788:
779:
778:
768:
758:
726:
720:
719:
693:
684:
678:
677:
675:
673:
657:
651:
650:
648:
646:
623:
617:
616:
606:
596:
572:
563:
562:
552:
520:
511:
510:
500:
468:
462:
461:
439:
424:
423:
401:
395:
394:
366:
178:edit on Wikidata
170:
133:
129:
125:
121:
116:
115:
114:
113:
106:
103:
102:
99:
96:
93:
90:
87:
83:
82:
79:
76:
73:
70:
67:
64:
61:
58:
55:
52:
49:
46:
43:
40:
37:
19:
18:
1855:
1854:
1850:
1849:
1848:
1846:
1845:
1844:
1825:
1824:
1823:
1814:
1751:
1700:
1684:
1656:
1613:
1590:
1558:Medical imaging
1541:
1530:Mediastinoscopy
1470:
1465:
1452:
1438:Transplantation
1433:Wedge resection
1358:
1238:
1232:
1202:
1201:
1161:
1157:
1112:
1108:
1098:
1096:
1081:
1077:
1046:
1042:
995:
991:
946:
939:
892:
885:
840:
836:
789:
782:
727:
723:
691:
685:
681:
671:
669:
658:
654:
644:
642:
624:
620:
573:
566:
521:
514:
469:
465:
458:
440:
427:
420:
402:
398:
367:
363:
358:
311:
283:
181:
166:
131:
127:
123:
119:
109:
108:
84:
34:
30:
17:
12:
11:
5:
1853:
1843:
1842:
1837:
1820:
1819:
1816:
1815:
1813:
1812:
1807:
1802:
1797:
1792:
1787:
1782:
1777:
1772:
1767:
1761:
1759:
1753:
1752:
1750:
1749:
1748:
1747:
1742:
1732:
1727:
1721:
1719:
1717:Oxygen therapy
1710:
1706:
1705:
1702:
1701:
1699:
1698:
1696:Blood gas test
1692:
1690:
1686:
1685:
1683:
1682:
1680:Sputum culture
1677:
1672:
1666:
1664:
1658:
1657:
1655:
1654:
1649:
1644:
1639:
1634:
1629:
1623:
1621:
1615:
1614:
1612:
1611:
1606:
1600:
1598:
1592:
1591:
1589:
1588:
1583:
1578:
1573:
1568:
1562:
1560:
1551:
1547:
1546:
1543:
1542:
1540:
1539:
1537:Nuss procedure
1533:
1532:
1527:
1525:
1517:
1516:
1511:
1506:
1501:
1496:
1491:
1489:
1486:pleural cavity
1477:
1475:
1454:
1453:
1451:
1450:
1445:
1440:
1435:
1430:
1425:
1420:
1418:
1410:
1409:
1404:
1402:
1394:
1393:
1388:
1383:
1381:Cricothyrotomy
1378:
1376:
1368:
1366:
1360:
1359:
1357:
1356:
1351:
1350:
1349:
1339:
1334:
1329:
1327:
1319:
1318:
1313:
1311:
1303:
1302:
1297:
1295:Rhinomanometry
1292:
1287:
1282:
1277:
1272:
1267:
1265:
1257:
1255:
1246:
1240:
1239:
1231:
1230:
1223:
1216:
1208:
1200:
1199:
1172:(1): 198–206.
1155:
1126:(10): 1173–5.
1106:
1075:
1040:
989:
937:
883:
834:
780:
721:
702:(9): 1004–14.
679:
652:
618:
564:
512:
483:(10): 839–50.
463:
456:
425:
418:
396:
360:
359:
357:
354:
353:
352:
347:
345:Pneumoconiosis
342:
337:
332:
327:
322:
317:
310:
307:
295:suction device
282:
279:
183:
182:
175:
172:
171:
164:
158:
157:
152:
146:
145:
142:
138:
137:
28:
24:
23:
15:
9:
6:
4:
3:
2:
1852:
1841:
1838:
1836:
1833:
1832:
1830:
1811:
1808:
1806:
1803:
1801:
1798:
1796:
1793:
1791:
1788:
1786:
1783:
1781:
1778:
1776:
1773:
1771:
1768:
1766:
1763:
1762:
1760:
1758:
1754:
1746:
1743:
1741:
1738:
1737:
1736:
1733:
1731:
1728:
1726:
1723:
1722:
1720:
1718:
1714:
1711:
1707:
1697:
1694:
1693:
1691:
1687:
1681:
1678:
1676:
1673:
1671:
1668:
1667:
1665:
1663:
1659:
1653:
1650:
1648:
1645:
1643:
1640:
1638:
1635:
1633:
1630:
1628:
1625:
1624:
1622:
1620:
1616:
1610:
1607:
1605:
1602:
1601:
1599:
1597:
1593:
1587:
1584:
1582:
1579:
1577:
1574:
1572:
1569:
1567:
1566:Bronchography
1564:
1563:
1561:
1559:
1555:
1552:
1548:
1538:
1535:
1534:
1531:
1528:
1526:
1524:
1523:
1519:
1518:
1515:
1512:
1510:
1507:
1505:
1502:
1500:
1497:
1495:
1494:Thoracentesis
1492:
1490:
1488:
1487:
1483:
1479:
1478:
1476:
1474:
1468:
1463:
1459:
1455:
1449:
1446:
1444:
1443:Decortication
1441:
1439:
1436:
1434:
1431:
1429:
1426:
1424:
1423:Pneumonectomy
1421:
1419:
1417:
1416:
1412:
1411:
1408:
1405:
1403:
1401:
1400:
1396:
1395:
1392:
1389:
1387:
1384:
1382:
1379:
1377:
1375:
1374:
1370:
1369:
1367:
1365:
1361:
1355:
1352:
1348:
1345:
1344:
1343:
1340:
1338:
1335:
1333:
1330:
1328:
1326:
1325:
1321:
1320:
1317:
1314:
1312:
1310:
1309:
1305:
1304:
1301:
1298:
1296:
1293:
1291:
1288:
1286:
1283:
1281:
1278:
1276:
1273:
1271:
1268:
1266:
1264:
1263:
1259:
1258:
1256:
1254:
1250:
1247:
1245:
1241:
1237:
1229:
1224:
1222:
1217:
1215:
1210:
1209:
1206:
1195:
1191:
1187:
1183:
1179:
1175:
1171:
1167:
1159:
1151:
1147:
1143:
1139:
1134:
1129:
1125:
1121:
1117:
1110:
1094:
1090:
1086:
1079:
1071:
1067:
1063:
1059:
1055:
1051:
1044:
1036:
1032:
1027:
1022:
1017:
1012:
1008:
1004:
1000:
993:
985:
981:
976:
971:
967:
963:
959:
955:
951:
944:
942:
933:
929:
924:
919:
914:
909:
905:
901:
900:Critical Care
897:
890:
888:
879:
875:
870:
865:
861:
857:
853:
849:
845:
838:
830:
826:
821:
816:
811:
806:
802:
798:
794:
787:
785:
776:
772:
767:
762:
757:
752:
748:
744:
740:
736:
732:
725:
717:
713:
709:
705:
701:
697:
690:
683:
667:
663:
656:
641:
637:
633:
629:
622:
614:
610:
605:
600:
595:
590:
586:
582:
578:
571:
569:
560:
556:
551:
546:
542:
538:
534:
530:
526:
519:
517:
508:
504:
499:
494:
490:
486:
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1407:Bronchoscopy
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1337:Laryngectomy
1332:Laryngoscopy
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200:bronchoscope
195:
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186:
1642:Capnography
1522:mediastinum
1509:Thoracotomy
1499:Pleurodesis
1467:mediastinum
1391:Tracheotomy
1342:Laryngotomy
1280:Somnoplasty
1275:Septoplasty
1270:Rhinoplasty
587:: 4883–96.
335:Lung cancer
244:ventilators
210:pathogenic
141:Other names
1829:Categories
1725:Intubation
1632:Spirometry
1514:Chest tube
1458:Chest wall
1316:Sinusotomy
1290:Rhinectomy
1285:Alarplasty
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356:References
315:Asbestosis
293:source, a
212:infections
1790:Nebulizer
1581:Spiral CT
1473:diaphragm
1428:Lobectomy
1347:Thyrotomy
1194:248326894
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731:Jerome KR
350:Silicosis
287:specimens
240:pneumonia
216:pneumonia
1662:Cytology
1399:bronchus
1364:Lower RT
1253:Upper RT
1186:35459766
1099:25 March
1070:19995769
1035:37798699
1026:10557288
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330:COVID-19
309:See also
220:COVID-19
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130:-lər lə-
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259:sputum
246:, and
228:lavage
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1550:Tests
1308:sinus
1190:S2CID
1146:S2CID
1050:Chest
692:(PDF)
204:lungs
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132:VAHZH
126:-vee-
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674:2020
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555:PMID
503:PMID
452:ISBN
414:ISBN
387:PMID
218:and
162:MeSH
1770:CPR
1174:doi
1128:doi
1058:doi
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