Bronchi Alveolar Lavage

  • What is it?
  • Description
  • What are the advantages and risks?

What is a Bronchi Alveolar Lavage?

Bronchoalveolar lavage (BAL) is a medical/nursing procedure in which a ventilated Patient(Ventilators (Breathing Machines)) gets fluids(10-20 ml sterile normal saline) squirted into the lungs through the Breathing Tube or Endotracheal Tube or Tracheostomy. Because your loved one is mechanically ventilated, he or she is getting regular suctions, in order to clear th airway, as he or she is unable to do so, whilst being mechanically ventilated. After the sterile normal saline has been flushed into the lungs, the sputum sample is taken by suctioning the fluis out of the lungs. The purpose of the procedure is to help in diagnosing pneumonia by obtaining a sputum specimen by ‘washing the airways’.

Description

If your loved one is mechanically ventilated on a Ventilator(Ventilators /Breathing Machines) and has a Breathing Tube or Endotracheal Tube or Tracheostomy inserted into their nose or mouth, the tube needs to be regularly cleared or suctioned in order to maintain a patent or clear airway and remove secretions. Throgh the endotracheal tube, a sputum sample can be attained with suctioning, in order to send the sample for testing to the labarotory, to determine possible sources of infection for Pneumonia. After the sterile normal saline has been flushed down the breathing tube, the suction catheter is then inserted into the lungs and after insertion it is withdrawn while applying suction and the collected sputum sample is collected in a sterile container (sputum trap) which is connected between the suction tubing and the suction catheter.

What are the advantages?

Its main advantage is to avoid a far more invasive, time consuming and risky Bronchoscopy, as BAL is a simple and relatively risk free method to quickly identify possible sources of Pneumonia.

Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors

What are the risks?

Main risks of performing a BAL are discomfort and de-oxigenation or lack of oxygen.

Depending on circumstances, your loved one may already be sedated while mechanically ventilated, but if not, the bedside nurse ensures your loved ones comfort is optimised before performing a BAL.

Before performing the BAL, your loved one also gets pre-oxygenated(100% oxygen given for a few minutes) before the procedure to avoid de-oxygenation. Furthermore, your loved one will be closely monitored(Bedside Monitors) throughout the procedure to minimise any risks.

Your loved one is closely monitored throughout and after the procedure. If you have any concerns or questions the ICU nurses and doctors will be happy to discuss them with you.

References

Arora, S.C., Mudaliar, Y.M., Lee, C., Mitchell, D., Iredell, J. & Lazarus, R. 2002, ‘ Non-bronchoscopic broncheoalveolar lavage in the microbiological diagnosis of pneumonia in mechanically ventilated patients’, Anaesthesia and Intensive Care, vol.30, no.1, 11-20.

Duff, C, 2003 ‘NB-BAL Specimen Collection’, Evidence Based Practice Guidelines Westmead Intensive Care.

Any Questions?

Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors.

All Intensive Care interventions and procedures carry a degree of potential risk even when performed by skilled and experienced staff. Please discuss these issues with the medical and nursing staff who are caring for your loved one.

The information contained on this page is general in nature and therefore cannot reflect individual Patient variation. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. INTENSIVE CARE HOTLINE attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual Patient. Please refer to the full disclaimer.

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