A small BAL is performed by instilling 20 ml and aspirating back at least 1 ml. Thirty patients with clinical pneumonia and receiving antibiotics had postmortem histologic proof of pneumonia. Microbiologic analysis of the antemortem BAL (within 48 h) and postmortem lung tissue were compared. Twenty-four patients (80 percent) had a positive BAL culture (no quantification was provided), and in 73 percent it correlated completely or partially with lung culture results. In a control group without clinical pneumonia, 51 samples with <1 percent SEC were obtained and bacterial growth was found in 19 (37 percent). Overall, this technique had a sensitivity of 80 percent and a specificity of 66 percent. buy cipro
A bronchoscopic technique to perform protected BAL (PBAL) using a balloon-tipped catheter with a distal ejectable diaphragm was recently described. The catheter is inserted through the suction channel of a large FOB (outside diameter [OD], 2.6 mm) and wedged proximally in the orifice of a subsegmental bronchus by inflating with 1.5 to 2 ml of air a recessed balloon positioned at the distal end. The BAL is performed through the irrigation lumen of the catheter after expelling the distal biodegradable diaphragm with a 3-ml sterile saline solution flush. In a prospective clinical study of 46 patients with lung disease, PBAL had ^1 percent SEC in 91 percent of all specimens and absence of growth in 59 percent of specimens from patients without pneumonia.
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