Pulmonary function changes after bronchoalveolar lavage in asthmatic patients

We monitored arterial oxygen saturation (StcO2) continuously using the OHMEDA Biox 3700 oximeter. We studied seven patients undergoing a 100 ml bronchoalveolar lavage (BAL-100), seven patients undergoing a 200 ml bronchoalveolar lavage (BAL-200), and seven patients during diagnostic fibreoptic bronchoscopy alone. Immediately following insertion of the bronchoscope a brief increase in StcO2 level (0.3-0.5%) was seen, followed by a gradual decline, never exceeding 2-5% during the diagnostic bronchoscopy. Introduction of lavage fluid into a segmental bronchus always produced a further decline in StcO2. In the BAL-100 group the fall did not exceed 7%, whereas in the BAL-200 group a fall of up to 15% from the baseline level was observed. Return to initial values was seen in most of the patients within 10 min following completion of the procedure. Only in those patients with the most profound StcO2 fall was this period increased, up to 30 min.

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“…Similar findings regarding desaturation measured directly have been reported previously by others [10,12]. CoLE eta/.…”

Section: Discussionsupporting

confidence: 92%

“…Return to prelavage S 1 8 values was generally slower in the BAL-200 group. This could imply that a reflex mechanism or the duration of the lavage procedure itself produced this phenomenon together with flooding of alveoli and surfactant inactivation [12].…”

Section: Discussionmentioning

confidence: 99%

Effect of different volumes of BAL fluid on arterial oxygen saturation

Pirozynski¹,

Sliwinski²,

Zielinski³

1988

Eur Respir J

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“…Some investigators have emphasized the existence of a higher risk in patients with impaired basal function due to restrictive 11,12 or obstructive diseases, although some results are controversial. [13][14][15][16][17] On the other hand, these studies were made with interferent factors (sedation, atropine, brochodilators, etc.) that difficult a proper scrutinization of the results.…”

Section: Introductionmentioning

confidence: 99%

Functional implications of BAL in the presence of restrictive or obstructive lung disease

Pedreira

Souza

Fiks

et al. 2007

Respiratory Medicine

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Most of the complications associated to bronchoscopy are related to changes of the respiratory function during or after its performance. Prevention of complications should be achieved by understanding the effects of bronchoscopic procedures and their relation to the pulmonary function deterioration. Previous studies regarding the functional impairment caused by bronchoalveolar lavage (BAL) were mostly limited by the presence of interferent factors such as sedative drugs. Furthermore, it is not clear whether or not patients with different ventilatory disturbances present the same functional response to bronchoscopy and BAL. The aim of this study was to determine the additional effects of BAL over the respiratory function deterioration related to bronchoscopy in patients with different respiratory function profiles (normal, restrictive and obstructive). Forty patients submitted to bronchoscopy without premedication were divided into four groups: group I-normal pulmonary function submitted to basic bronchoscopy; group II-bronchoscopy in combination with BAL, subdivided according to pulmonary function: group IIa (normal function), group IIb (restrictive ventilatory disturbances) and group IIc (obstructive ventilatory disturbances). Spirometry was made before and after the bronchoscopic procedure. Baseline hemoglobin saturation was compared to the lowest level during the procedure. Functional worsening caused by the procedure was observed with a decrease in forced vital capacity (FVC), forced expiratory volume in the first second (FEV(1)) and Hemoglobin saturation in all groups. Comparison between groups showed no significant difference regarding the changes in FVC (P=0.8324), FEV(1) (P=0.6952) and hemoglobin saturation (P=0.5044). We conclude that standardized BAL, like the one used in our study, does not result in an increased risk for ventilatory impairment compared to bronchoscopy itself, independently of the presence of previous respiratory disease.

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Pulmonary function changes after bronchoalveolar lavage in asthmatic patients

Cited by 2 publications

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Effect of different volumes of BAL fluid on arterial oxygen saturation

Effect of different volumes of BAL fluid on arterial oxygen saturation

Functional implications of BAL in the presence of restrictive or obstructive lung disease

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