The Role of Bronchoalveolar Lavage in Diagnosing Nonopportunistic Bacterial Pneumonia (6)

In: Pulmonary function

28 Apr 2013

Risk
The complications of BAL are mainly those that accompany FOB and, in patients without respiratory failure, are usually minor. The most common complication encountered during or after bronchoscopy with BAL in patients receiving mechanical ventilation is a drop in Pk02. In one study, significant hypoxemia (Pa02 <60 mm Hg on 80 percent FIo2) was observed in 13 percent (14/117) and was linked to the severity of pulmonary dysfunction and the decrease in alveolar ventilation. Hypoxemia was more frequent in the one with adult respiratory distress syndrome (ARDS) and in those who “fought” the ventilator during the procedure; the mean drop in Pa02 was 26 percent and persisted for up to 2 h. Others have reported an increase in FIo2 requirements after bronchoscopy in 23 percent of ventilated patients. buy yasmin online

The size of the endotracheal tube (in relation to the size of the bronchoscope) was found in one study to be an important factor in limiting lung inflation and in decreasing ventilation and Pa02. In intubated patients, therefore, diagnostic bronchoscopy should be performed with due caution and with continuous monitoring of exhaled volumes and oxygen saturation, while providing a high FIo2 (80 to 100 percent). Other complications have included arrhythmias, transient worsening in pulmonary infiltrates, and fever.


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