Bacteremia During Bronchoalveolar Lavage

Ra, Balk; Rw, Bradsher; Jacobs, RF; Jones, R L

doi:10.1097/00007611-198612000-00006

Cited by 2 publications

(2 citation statements)

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“…Infection surveillance alone could be performed with a smaller volume (eg 120 ml 5 ) and a lower fever rate would then be expected. The fever is associated with pyrogenic cytokine release rather than bacteraemia in most cases, 15,20,21 although bacteraemia has been demonstrated after rigid bronchoscopy. 22 Our study has not demonstrated any clear-cut cases of BAL during neutropenia causing bacteraemia: two of the three neutropenic subjects who were found to have pathogenic bacteria in BALF subsequently developed fever, but so did four others, and none of the BALF organisms were found on blood culture.…”

Section: Discussionmentioning

confidence: 99%

The safety and usefulness of routine bronchoscopy before stem cell transplantation and during neutropenia

Whittle

Davis

Johnson

et al. 1999

Bone Marrow Transplant

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Summary:Fibreoptic bronchoscopy with bronchoalveolar lavage (BAL) is used for clinical investigation and research into pulmonary complications of stem cell transplantation. Adverse effects of BAL are common in neutropenic patients with lung disease; there are few data on its safety when used routinely in transplant recipients without lung impairment. We describe the complications and usefulness for infection surveillance of routine BAL pre-transplantation and during neutropenia. Thirtythree patients before autologous or allogeneic BMT or PBSCT (B1) and 24 during post-transplant neutropenia (B2) underwent BAL; patients with pulmonary disease were excluded. Subjects were monitored for adverse effects, and BAL fluid was examined for pathogens. Complications of B2 were compared with events seen in 35 neutropenic patients who did not undergo BAL (C).Eighteen percent B1 and 33% B2 subjects showed complications of BAL. Fever occurred in 12% B1 and 26% previously afebrile B2 subjects, compared to 11% of C (P = 0.3). Epistaxis occurred in one B2 subject and two C. Potentially pathogenic organisms were isolated from 18% B1 and 13% B2 BAL fluids; none caused later respiratory infection. Bronchoscopy and BAL pre-and post-transplant had acceptable safety for a research procedure, but were not clinically helpful for infection surveillance.

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Section: Discussionmentioning

confidence: 99%

The safety and usefulness of routine bronchoscopy before stem cell transplantation and during neutropenia

Whittle

Davis

Johnson

et al. 1999

Bone Marrow Transplant

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“…Bronchoalveolar lavage has been widely and effectively used to collect lung fluid from ventilated subjects [26], but questions remain regarding its correlation with bronchial biopsy results and repeatability [27]. Furthermore, although BAL is generally considered to be safe [27][28][29], transient adverse effects have been widely described [26,[30][31][32][33][34]. The recent dramatic increase in research interest in lung fluid has certainly been influenced by the fact that EBC collection has emerged as a potential noninvasive alternative to induced sputum and BAL fluid for measuring some inflammatory markers in nonventilated subjects.…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of exhaled breath condensate collection in ventilated infants and children

Müller

Morini²,

Eaton

et al. 2006

European Respiratory Journal

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The aim of this study was to develop a technique for the collection of exhaled breath condensate (EBC) from ventilated children and assess its safety and feasibility. Collection of EBC is used to investigate markers of oxidative stress in the lower airway. No studies have assessed its safety in ventilated children.An in vitro model was developed by connecting a ventilator to an artificial lung; 14 clinical and ventilatory parameters were measured during EBC collection from ventilated children. Levels of 8-isoprostane were measured following collection with and without humidification of the inhaled gas.Amount of water vapour collected was linearly related to time and to minute ventilation in the in vitro model. EBC collections (n568) were made from ventilated children. In the nonhumidified group, the mean (range) positive end-expiratory pressure increased by 4.1% (2.8-5.5%) and the peak inspiratory flow decreased by 6.1% (11.0-1.3%) during collection. Detectable levels of 8-isoprostane were only found in 10 out of 18 nonhumidified EBC samples (median (range) 4.7 pg?mL -1 (0-5.8)).Collection of exhaled breath condensate from ventilated infants and children is feasible and safe. Discontinuation of humidification is likely to be important in standardising the measurement of inflammatory parameters in exhaled breath condensate collected from ventilated children.

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Bacteremia During Bronchoalveolar Lavage

Cited by 2 publications

References 0 publications

The safety and usefulness of routine bronchoscopy before stem cell transplantation and during neutropenia

The safety and usefulness of routine bronchoscopy before stem cell transplantation and during neutropenia

Safety and feasibility of exhaled breath condensate collection in ventilated infants and children

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