Bronchoalveolar Lavages for Cytologic Assessment in Intensive Care Unit Patients

Bronchoalveolar Lavages in the Intensive Care Unit : Indications, Adverse Respiratory Effects, Contribution to Diagnosis and Therapy. A Multicenter, Prospective, Observational Study

Little is known about bronchoalveolar lavages performed for cytological assessment during bronchial fibroscopy in critically ill patients. Frequency of use, indications, actual contribution to diagnosis and therapeutic decision, and complications have not been extensively assessed.

The primary objective of this multi center, prospective, observational study is to describe the frequency of use of bronchoalveolar lavages for cytological assessement in critically ill patients, identify their indications, assess their contribution to diagnosis and therapeutic decisions, and estimate the frequency of induced respiratory events.

Secondary objectives will be to

• assess the frequency of poor quality bronchoalveolar lavages (as defined by either more than 5% bronchial epithelial cell count to less than 50,000 alveolar cells per mL)
• assess the contribution of a given bronchoalveolar lavage to the diagnostic work up
• assess the contribution of a given bronchoalveolar lavage results to therapeutic decision
• assess the induced short term respiratory side effects
• identify risk factors for poor respiratory tolerance

Inclusion Criteria:

• adult patient (> 18 yr-old) hospitalized in intensive care unit with acute and/or chronic lung disease that need bronchoalveolar lavage as part of routine diagnostic work up
• patient's or family consent

Exclusion Criteria:

• consent not obtained
• patient already included at previous bronchoalveolar lavage of during previous hospitalization
• absence of social security number
• age < 18yr
• pregnant woman