Utility of bronchoalveolar lavage in the management of immunocompromised patients presenting with lung infiltrates

BMC Pulmonary Medicine
Randall ChooDevanand Anantham

Abstract

Bronchoalveolar lavage (BAL) is utilized for diagnosing lung infiltrates in immunocompromised. There is heterogeneity in the data and reported diagnostic yields range from 26 to 69%. Therefore, selection criteria for BAL to maximize yield and minimize complications are unclear. Objectives of this study were to determine the diagnostic yield and complication rate of BAL in immunocompromised patients presenting with lung infiltrates, and identify factors impacting these outcomes. Exploratory aims included characterization of pathogens, rate of treatment modification and mortality. Retrospective study from January 2012 to December 2016. Patients on mechanical ventilation were excluded. Positive diagnostic yield was defined as confirmed microbiological or cytological diagnosis. A total of 217 patients were recruited (70.1% male and mean age: 51.7 ± 14.6 years). Diagnostic yield was 60.8% and complication rate 14.7%. Complications (hypoxemia and endobronchial bleeding) were all sell-limiting. Treatment modification based on BAL results was 63.3%. In 97.0% an infectious aetiology was identified. HIV infection (OR 5.304, 95% CI 1.611-17.458, p = 0.006) and severe neutropenia (OR 4.253, 95% CI 1.288-14.045, p = 0.018) were associated w...Continue Reading

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Citations

Dec 24, 2019·Expert Review of Respiratory Medicine·Joanna Domagala-Kulawik
Mar 29, 2020·Annals of the American Thoracic Society·Joseph M GarlandEdward Wing
Nov 12, 2019·Respiratory Medicine Case Reports·Kai Chin Poh, Shuwei Zheng
Aug 12, 2020·European Journal of Internal Medicine·Sophie FrantzMartin Kolditz
Mar 16, 2021·Mycoses·Valliappan MuthuRitesh Agarwal

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Methods Mentioned

BETA
bronchoalveolar lavage
biopsies
sedation
antigen assay
enzyme-linked immunosorbent assay
lavage

Clinical Trials Mentioned

NCT01374542

Software Mentioned

SPSS

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