title: Diagnostic role of rapid on-site cytologic examination (ROSE) of broncho-alveolar lavage in ALI/ARDS.
abstract: BACKGROUND
  While bronchoscopy should be considered in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in which the cause cannot be determined from history or clinical and laboratory data, there are no studies about the utility of rapid on-site examination (ROSE) of broncho-alveolar lavage for identification, as early as possible, of the pathological condition underlying the onset of this condition. The aim of this prospective, observational study was to evaluate the diagnostic role of ROSE of BAL in ALI/ARDS.
  
  
  METHODS
  71 patients with ALI/ARDS underwent bronchoalveolar lavage, and one part of the sample was examined with ROSE. The on-site report was categorized as diagnostic (specific diagnosis), presence of atypical reactive type II pneumocytes with no further comments or not diagnostic.
  
  
  RESULTS
  ROSE of bronco-alveolar lavage yielded 29 (41%) specific diagnoses, revealed typical features of diffuse alveolar damage without a specific diagnosis in 28 patients (39%) and did not reveal a specific diagnosis in the remaining 14 cases (20%).
  
  
  CONCLUSIONS
  The results of this study show that, in patients with ALI/ARDS, bronchoalveolar lavage with ROSE is diagnostic in 40% of cases: ROSE may therefore spare lung biopsies and improve the prognosis of patients with ARDS (immunocompetent or not) as therapy could be started or modified at a very early phase.
authors.affiliation: Department of Diseases of the Thorax, Pulmonology Unit, Morgagni-Pierantoni Hospital, Forli, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ravaglia
authors.forename: C
authors.initials: C
authors.lastname: Gurioli
authors.forename: G
authors.initials: G
authors.lastname: Casoni
authors.forename: M
authors.initials: M
authors.lastname: Romagnoli
authors.forename: S
authors.initials: S
authors.lastname: Tomassetti
authors.forename: C
authors.initials: C
authors.lastname: Gurioli
authors.forename: R M
authors.initials: RM
authors.lastname: Corso
authors.forename: G
authors.initials: G
authors.lastname: Poletti
authors.forename: A
authors.initials: A
authors.lastname: Dubini
authors.forename: A
authors.initials: A
authors.lastname: Marinou
authors.forename: V
authors.initials: V
authors.lastname: Poletti
mesh_terms: D055371:Acute Lung Injury / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018893:Bronchoalveolar Lavage / Q000295:instrumentation / Q000379:methods*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010338:Pathology, Clinical / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000473:pathology*; D055815:Young Adult