LBA in the ICU: Safety and Diagnostic Value

LBA is a valuable diagnostic tool for the intensivist faced with a patient presenting with acute respiratory failure and recently developed bilateral alveolar-interstitial radiographic findings. This clinical and radiological presentation defines acute diffuse infiltrative pneumonitis (DIP), which may or may not be of infectious origin. Bronchial lavage (BL) is primarily indicated in two situations: 1) To identify pathogens in cases of acute infectious DIP in immunocompromised patients; 2) To confirm or rule out certain etiologies of acute non-infectious DIP, which constitutes a broad and highly heterogeneous group. This book was developed to address three objectives: first, it details the precautions required to ensure the safety of the bronchoscopic biopsy procedure; second, it reviews the etiologies of acute DIP requiring a bronchoscopic biopsy; and finally, it reports on the experience of a respiratory intensive care unit that relies on bronchoscopic biopsy.