What is the role of bronchoalveolar lavage (BAL) in the diagnosis of fat embolism?

Updated: Mar 26, 2018
  • Author: Constantine S Bulauitan, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Bronchoalveolar lavage (BAL) specimens have been evaluated in trauma patients and sickle-cell patients with acute chest syndrome, and the results have been mixed. [22, 23]

Lipid inclusions commonly appear in patients with traumatic and nontraumatic respiratory failure; the standard cutoff in the BAL studies—5% fat-containing macrophages—results in a low specificity for the test. To improve specificity, some authors suggest raising the cutoff to 30%. At present, using BAL to aid in the diagnosis of FES or to predict its likelihood is controversial.


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