title: [Mini bronchoalveolar lavage in patients with severe respiratory failure].
abstract: BACKGROUND
  To recognize the etiological agent responsible for severe acute respiratory failure (ARF) in patients in mechanical ventilation (MV) is important to determine their treatment and prognosis, and to avoid the excessive use of antibiotics. Mini bronchoalveolar lavage (mini BAL) is a blind, non bronchoscopic procedure, used to obtain samples from the lower respiratory tract from patients on mechanical ventilation (MV).
  
  
  OBJECTIVE
  To assess the feasibility, complications and preliminary results of mini BAL among patients with severe ARF on MV.
  
  
  METHODS
  Prospective study in 17 patients with acute lung injury (ALI ) or acute respiratory distress syndrome (ARDS) on MV and with negative conventional microbiological studies. Mini BAL was performed using standardized protocols. Hemodynamic and respiratory parameters where measured before and after the procedure. Samples obtained were sent to quantitative cultures.
  
  
  RESULTS
  At baseline: APACHE II score of 22 ± 6,7, PaO2/FiO2 ratio was 176.6 ± 48.6 and the oxygenation index was 9.74 ± 3.78. All procedures were performed by an ICU resident. Thirty five percent of the procedures had positive cultures and no complications related to the procedures were reported. The procedure lasted an average of 12 minutes and the instilled and rescued volume were 60 ml and 19.6 ml, respectively. There were no significant differences between hemodynamic and respiratory variables before and after the procedure.
  
  
  CONCLUSIONS
  Mini BAL is a safe, fast and easy technique for obtaining samples from the inferior airway in patients with ALI or ARDS on MV.
authors.affiliation: Departamento de Medicina Intensiva, Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. andresen@med.puc.cl
authors.forename: Max
authors.initials: M
authors.lastname: Andresen
authors.forename: Marcelo
authors.initials: M
authors.lastname: Mercado
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zapata
authors.forename: Andrea
authors.initials: A
authors.lastname: Bustamante
authors.forename: Tomás
authors.initials: T
authors.lastname: Regueira
mesh_terms: D018806:APACHE; D018893:Bronchoalveolar Lavage / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D055370:Lung Injury / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000209:etiology*