Bronchial Washing (Bronchoalveolar Lavage) Specimen
Norm of Bronchial Washing (Bronchoalveolar Lavage) Specimen
Negative for culture and cytologic testing.
Usage of Bronchial Washing (Bronchoalveolar Lavage) Specimen
Diagnosis of infections, for example, Mycobacterium szulgai and Bipolaris hawaiiensis, and pathologic processes in the lungs.
Description of Bronchial Washing (Bronchoalveolar Lavage) Specimen
Procedure useful to obtain respiratory tract specimens for culture and cytologic testing when very few secretions are present. Specimens are obtained from a normal saline wash, which is instilled into the bronchi and then suctioned out. Saline may be instilled through a bronchoscope, an endotracheal tube, or a tracheal tube. A bronchoalveolar wash will provide a specimen from the alveoli and is done by insertion of the flexible fiberoptic bronchoscope as far into the bronchiole as possible and instillation of the saline at that point. This procedure is used when adequate deep sputum specimens cannot be obtained and is often helpful in the diagnosis of Pneumocystis pneumonia.
Professional Considerations of Bronchial Washing (Bronchoalveolar Lavage) Specimen
Consent form is NOT required unless the washing is done by bronchoscopy. See Bronchoscopy for risks and contraindications if bronchoscopy is used to obtain the specimen.
Preparation
- Obtain a specimen trap, suction tubing, a sterile suction catheter, and sterile gloves.
- Prepare a wall suction or a suction machine.
- If the washing is performed during bronchoscopy, obtain sterile specimen containers for the bronchoscope.
- See Bronchoscopy, if this procedure is used.
Procedure
- A specimen trap is inserted into the suctioning line from the bronchoscope, or between the suctioning catheter and the suctioning line.
- Up to 20 mL of normal saline is instilled into the respiratory tract through the bronchoscope, the endotracheal tube, or the tracheal tube, and the specimen is obtained when suction is applied to the bronchoscope catheter or suction catheter.
Postprocedure Care
- Write the time of specimen collection and any current antibiotic or antifungal therapy on the laboratory requisition.
- See Bronchoscopy if this procedure is used.
Client and Family Teaching
- See Bronchoscopy if this procedure is used.
- Results are normally available within 1–2 days.
Factors That Affect Results
- Bronchial washing specimens must be collected using a sterile technique.
Other Data
- May be used to diagnose Pneumocystis carinii in clients with AIDS.
- High number of neutrophils found in bronchial washing fluid of COPD clients.
