Nonbronchoscopic Methods [Nonbronchoscopic Bronchoalveolar Lavage (BAL), Mini-BAL, Blinded Bronchial Sampling, Blinded Protected Specimen Brush] to Investigate for Pulmonary Infections, Inflammation, and Cellular and Molecular Markers: A Narrative Review

Without reliable diagnostic modalities, determination of the nature of illness can be equivocal, and thus could subject patients to no helpful treatments or unfounded medical interventions and associated financial burdens. Several diagnostic techniques for health care professionals to investigate the possibility of respiratory infection, with emphasis on nonbronchoscopic (NB) methods [nonbronchoscopic bronchoalveolar lavage (NB-BAL), mini-BAL, blinded bronchial sampling, and blinded protected specimen brush], are discussed here. These NB techniques, like bronchoscopic methods, are invasive ways to investigate for lung infections. Each approach may be superior to relatively less invasive means of respiratory diagnosis by endotracheal aspiration or sputum induction. Although the diagnostic effectiveness of bronchoscopic and NB methods is similar, NB methods are conducted in the absence of visualization, and thus their blinded operation introduces various use limitations. However, NB methods seem to be more manageable than bronchoscopic techniques, as indicated by NB association with a safer use profile, greater convenience, an obviated requirement for operation by a physician, and lesser financial costs. Moreover, NB methods can be used for surveillance to explore the possibility of ventilator-associated pneumonia, nosocomial pneumonia, and community-acquired pneumonia. In addition, NB methods can direct antibiotic stewardship in individuals having respiratory infections, and d...
Source: Clinical Pulmonary Medicine - Category: Respiratory Medicine Tags: Topics in Pulmonary Medicine Source Type: research