What is the role of bronchoscopy in the diagnosis of acute respiratory distress syndrome (ARDS)?

Updated: Mar 27, 2020
  • Author: Eloise M Harman, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

With all of the below-mentioned benefits of bronchoscopy, it is worth considering the risk of losing alveolar recruitment via near total occlusion of the endotracheal tube by the bronchoscope in patients with severe ARDS.

Bronchoscopy may be considered to evaluate the possibility of infection, alveolar hemorrhage, or acute eosinophilic pneumonia in patients acutely ill with bilateral pulmonary infiltrates. Culture material may be obtained by wedging the bronchoscope in a subsegmental bronchus and collecting the fluid suctioned after instilling large volumes of nonbacteriostatic saline (bronchoalveolar lavage; BAL). The fluid is analyzed for cell differential, cytology, silver stain, and Gram stain and is quantitatively cultured.


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