Purpose of bronchoalveolar lavage, alveolar lavage

This is an automatically translated article.

The article was professionally consulted with Doctor CKII Nguyen Van Thai - Department of Medical Examination & Internal Medicine - Vinmec International General Hospital Da Nang.
Bronchoscopy, alveolar lavage is a flexible bronchoscopy technique aimed at diagnosing and treating a number of diseases related to the lungs.

1. What is bronchoalveolar lavage, alveolar lavage?

Bronchoscopy, alveolar lavage is a technique performed through flexible bronchoscopy to obtain a sample of a solution containing cells and non-cellular components of the small airways and alveoli by injecting solution. physiological saline solution into the bronchi, alveoli.

2. Purpose of bronchoscopic and alveolar lavage

From December 2006 to March 2008, experts conducted a study on 30 patients with silicosis to evaluate the initial results of bronchial and alveolar lavage in the treatment of the disease. After clinical examination and pulmonary ventilation measurement before and after bronchoalveolar lavage, the results showed that compared with before bronchoalveolar lavage, the symptoms of the disease after bronchoalveolar lavage, such as cough, expectoration sputum decreased markedly (from 76% to 33.3%), all symptoms of respiratory symptoms were reduced, bronchial syndrome, coagulation syndrome were all gone. After bronchoalveolar lavage, autonomic dysfunction disappeared and returned to normal.
Besides, applying bronchoalveolar lavage endoscopic technique is also aimed at diagnosing lung diseases, including:
Malignant pathologies Lung infections Attenpneumonia Pneumonia Pneumonia Interstitial lung disease alveolar protein The patient coughs up blood for a long time without a clear cause The patient has a pleural effusion of unknown cause.

3. Contraindications to perform bronchoalveolar lavage, alveolar lavage

There are no absolute contraindications when performing bronchoscopy and alveolar lavage. Relative contraindications in the presence of the following conditions:
Patient is severely hypoxic. Increased blood CO2 Forced breathing per second FEV1< 1 liter. The patient has severe bronchospasm. Hemodynamic instability Severe heart rate disturbance Unstable angina Aortic aneurysm Uncorrectable coagulopathy The patient did not agree to perform endoscopy.

4. Procedure for endoscopic washing of bronchi and alveoli

The operator must have experience and technical proficiency
Check the vehicle and equipment is complete
Check the patient
Check the medical record
Carry out the procedure:
Place the patient in supine position, let the head lie down high if the patient has difficulty breathing Use 2% lidocaine to numb the nose and throat Endoscopy images are recorded in the computer Perform the endoscope through the nose or mouth to the glottis Perform additional anesthesia with vocal cords , gas, bronchi bilaterally Observing the bronchi: the healthy side first then the injured side Attached to the bronchoscope and suction line sterile collection device Perform bronchoalveolar lavage by inserting the bronchoscope to the segment , push down the bronchoscope so that the bronchoscope seals the bronchus to be washed but do not push too hard, causing damage to the bronchi Inject 50ml of 0.9% sodium chloride solution slowly Take a As much rinse fluid as possible enters the sterile collection device by gently aspirating and holding the bronchoscope in place. Perform irrigation approximately 3 times. Carrying out the sterile collection device Remove the bronchoscope.

5. Management of complications when performing bronchoscopic and alveolar lavage

Patients with hypoxemia:
Ensure adequate oxygenation of the patient by increasing oxygen flow Stop bronchoscopy if hypoxemia does not improve Patient has laryngeal, bronchial spasms:
Common Occurs in cases of increased bronchial reactivity, such as bronchial asthma. In order to promptly handle complications, place a peripheral intravenous line before bronchoscopy. Management: stop bronchoscopy , alveoli, intravenous corticosteroid injection, intravenous infusion of Salbutamol, aerosol Ventolin, Pulmicort. Patients with acute respiratory failure:
Stop the procedure To optimize the patient's oxygen saturation by increasing the flow of breathing oxygen Initiate a peripheral intravenous line, Salbutamol infusion, IV Corticosteroids, aerosol Ventolin, Pulmicort. Patients with hypertension:
Use Furosemide for intravenous injection. Patients with infection:
Instruments and endoscopes need to be well disinfected. Patients who are allergic to Lidocaine :
For those with a history of drug allergy, a test should be performed. Thus, the purpose of bronchoscopy and alveolar lavage is not only to treat diseases, but also to help diagnose lung diseases such as malignancies, lung infections, atelectasis, gas foreign bodies. – bronchi, pneumococcal disease, interstitial lung disease, alveolar protein accumulation; clearly determine the cause of prolonged hemoptysis, pleural effusion,...
At Vinmec International General Hospital, flexible bronchoscopy technique is performed on modern mechanical means. Modern technology, this technique does not make the patient uncomfortable during endoscopy: Choking, feeling asphyxiated... Before the procedure, the patient will be anesthetized and carefully controlled the airway to ensure safety. To ensure safety and minimize irritation or discomfort for the patient, the doctor will then perform the endoscopic technique, remove the foreign body and then check and control to ensure there are no complications for the patient.
For consultation and registration for bronchoscopy with anesthesia at Vinmec International Hospital, please book an appointment on the website for service.

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