What are the factors affecting the recovery rate of bronchoalveolar lavage fluid?

Shikano, Kohei; Abe, Mitsuhiro; Shiko, Yuki; Tsushima, Kenji; Yoshioka, Keiichiro; Ishiwata, Tsukasa; Kawasaki, Takeshi; Ikari, Jun; Terada, Jiro; Kawasaki, Yohei

doi:10.1111/crj.13462

Cited by 5 publications

(13 citation statements)

References 20 publications

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“…Low fractional return is associated with both restrictive and obstructive lung disease, and yield below 30% can indicate undersample of the distal airways. Of note, undersampling of the distal airways would be associated with greater microbial recovery and lower AEC recovery, which is the opposite of what we found in our patients with pulmonary restriction (49)(50)(51)(52)(53)(54). Last, younger children were necessarily excluded because of their inability to perform PFTs.…”

Section: Discussioncontrasting

confidence: 64%

Pulmonary microbiome and gene expression signatures differentiate lung function in pediatric hematopoietic cell transplant candidates

et al. 2022

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Impaired baseline lung function is associated with mortality after pediatric allogeneic hematopoietic cell transplantation (HCT), yet limited knowledge of the molecular pathways that characterize pretransplant lung function has hindered the development of lung-targeted interventions. In this study, we quantified the association between bronchoalveolar lavage (BAL) metatranscriptomes and paired pulmonary function tests performed a median of 1 to 2 weeks before allogeneic HCT in 104 children in The Netherlands. Abnormal pulmonary function was recorded in more than half the cohort, consisted most commonly of restriction and impaired diffusion, and was associated with both all-cause and lung injury–related mortality after HCT. Depletion of commensal supraglottic taxa, such as Haemophilus , and enrichment of nasal and skin taxa, such as Staphylococcus , in the BAL microbiome were associated with worse measures of lung capacity and gas diffusion. In addition, BAL gene expression signatures of alveolar epithelial activation, epithelial-mesenchymal transition, and down-regulated immunity were associated with impaired lung capacity and diffusion, suggesting a postinjury profibrotic response. Detection of microbial depletion and abnormal epithelial gene expression in BAL enhanced the prognostic utility of pre-HCT pulmonary function tests for the outcome of post-HCT mortality. These findings suggest a potentially actionable connection between microbiome depletion, alveolar injury, and pulmonary fibrosis in the pathogenesis of pre-HCT lung dysfunction.

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Section: Discussioncontrasting

confidence: 64%

Pulmonary microbiome and gene expression signatures differentiate lung function in pediatric hematopoietic cell transplant candidates

et al. 2022

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“…The recovery rate was calculated as the ratio of the amount of recovery fluid after instillation to the amount of extracted fluid. The BAL failure group was identified as having a total recovery rate of less than 30%, which is considered a deterioration for an effective diagnosis in patients with interstitial lung disease [1,2].…”

Section: Definitionmentioning

confidence: 99%

“…To conduct BAL, the tip of the bronchoscope was placed into the wedge position in a lobe/segment/subsegmental bronchus. BAL was performed with three aliquots of 50 ml physiological saline at room temperature; using a method common in Japan, the saline was gradually instilled and then gently suctioned back through an instrumentation channel [2]. The recovery rate of BAL from the 50-, 100-, and 150-mL injections were labelled the recovery rates of the 1 st , 2 nd , and 3 rd aliquots, respectively.…”

Section: Bal Proceduresmentioning

confidence: 99%

“…Bronchoalveolar lavage (BAL) is an established diagnostic tool for interstitial lung and infectious bronchopulmonary diseases [1]. Generally, the low BAL recovery rate is a poor study, and the BAL recovery rate should be more than 30% for an effective diagnosis [1,2] because a total volume of retrieved fluid less than 30% may provide a misleading cell differential [3]. The predicted factors for a low BAL recovery rate were reported, such as male sex, elderly age, smoking history, chronic obstructive pulmonary disease (COPD), performing BAL at bronchi other than the middle lobe or lingula, and low forced expiratory volume in 1 second (FEV 1 ) divided by forced vital capacity (FEV 1 /FVC) [1,2,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Generally, the low BAL recovery rate is a poor study, and the BAL recovery rate should be more than 30% for an effective diagnosis [1,2] because a total volume of retrieved fluid less than 30% may provide a misleading cell differential [3]. The predicted factors for a low BAL recovery rate were reported, such as male sex, elderly age, smoking history, chronic obstructive pulmonary disease (COPD), performing BAL at bronchi other than the middle lobe or lingula, and low forced expiratory volume in 1 second (FEV 1 ) divided by forced vital capacity (FEV 1 /FVC) [1,2,4,5]. However, few reports have compared recovery rates of <30% and recovery rates of �30% [5]; there have been no reports investigating a target bronchus for BAL.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of predicted factors for bronchoalveolar lavage recovery failure: An observational study

et al. 2022

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Background The bronchoalveolar lavage (BAL) recovery rate should generally be more than 30% for effective diagnosis. However, there have been no reports investigating a target bronchus for BAL, and the cause of BAL recovery failure is uncertain. Therefore, this study detected predictive factors for BAL recovery failure through investigations on a target bronchus for BAL by using a 3D image analysis system. Therefore, this study detected predictive factors for BAL recovery failure. Materials and methods We retrospectively collected data from 338 adult patients who underwent BAL procedures at Fukujuji Hospital from June 2018-March 2022. Factors correlated with the BAL recovery rate were detected. Furthermore, the patients were divided into the failure group (recovery rate <30%; 36 patients) and the success group (recovery rate ≥30%; 302 patients), and data were compared between the two groups by analysing the target bronchus by using a 3D image analysis system. Results The patients in the failure group were older (median 74.5 years old [IQR 68.0–79.0] vs. median 70.0 years old [IQR 59.0–76.0], p = 0.016), more likely to be male (n = 27 [75.0%] vs. n = 172 [57.0%], p = 0.048), more likely to have COPD (n = 7 [19.4%] vs. n = 14 [4.6%], p = 0.003), and more likely to perform a target site of BAL other than the middle/lingual lobe (n = 11 [30.5%] vs. n = 35 [11.6%], p = 0.004) than those in the success group. The area of the bronchial wall was positively related to the recovery rate (r = 0.141, p = 0.009), and the area of the bronchial wall in the failure group was lower than that in the success group (median 10.5 mm2 [interquartile range (IQR) 8.1–14.6] vs. median 14.5 mm2 [11.4–19.0], p<0.001). Conclusion The study shows that a thin bronchial wall, COPD, and a target site of BAL other than the middle/lingual lobe were identified as the predicted factors for BAL recovery failure. The weakness of the bronchial wall might cause bronchial collapse during the BAL procedure.

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May noninvasive mechanical ventilation and/ or continuous positive airway pressure increase the bronchoalveolar lavage salvage in patients with pulmonary diseases? Randomized clinical trial - Study protocol

Danel,

Tobiczyk,

Warcholiński

et al. 2023

Advances in Medical Sciences

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What are the factors affecting the recovery rate of bronchoalveolar lavage fluid?

Cited by 5 publications

References 20 publications

Pulmonary microbiome and gene expression signatures differentiate lung function in pediatric hematopoietic cell transplant candidates

Pulmonary microbiome and gene expression signatures differentiate lung function in pediatric hematopoietic cell transplant candidates

Analysis of predicted factors for bronchoalveolar lavage recovery failure: An observational study

May noninvasive mechanical ventilation and/ or continuous positive airway pressure increase the bronchoalveolar lavage salvage in patients with pulmonary diseases? Randomized clinical trial - Study protocol

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