The Annals of Thoracic Surgery, Vol 30, 427-432, Copyright © 1980 by The Society of Thoracic Surgeons
Clinical evaluation of bronchopulmonary lavage using the flexible fiberoptic bronchoscope
J Garvey, J Guarneri, F Khan and J Goldstein
Thirty-three patients had segmental and lobar bronchopulmonary lavage using
three types of flexible fiberoptic bronchoscopes. A maximum volume of 300
ml of normal saline solution at room temperature was used. Lavage was
effective for removing large numbers of alveolar macrophages (mean, 17
million) and proteinaceous material (mean, 0.18 mg per milliliter) that
helped enhance the antibacterial properties of the macrophages. Transient
shunting (mean fall in partial pressure of arterial oxygen, 65 mm Hg) and
alveolar filling that reverted to normal in 3 hours were noted. The
procedure averaged 45 minutes and was as simple as bronchoscopy. The larger
the internal diameter of the bronchoscope (> 2.6 mm) the better suited
it was for lavage. Sequential segmental lavage seems to offer the
advantages of simplicity and technical ease over isolated lobar lavage with
a balloon-tipped bronchoscope. It also has the advantage of simplicity over
whole-lung lavage.