Abstract
Background. Bronchoalveolar lavage (BAL) has been applied since the 1970s as a method of diagnosing diffuse and infectious lung diseases. However, the complication rate of definitely indicated BAL in Japan was reported to be 0.77% in 2010. Purpose. The present study aimed to determine complications of definitely indicated BAL at a single institution and the factors that might be involved. We also aimed to define the background factors associated with complications in patients with idiopathic interstitial pneumonia. Methods. This retrospective study analyzed the medical records and bronchoscopy reports of 276 patients who were assessed using BAL at Kyushu University Hospital Respiratory Department between January 1, 2007 and December 31, 2011. Results. The overall complication rate of BAL was 50% of the total number of patients and 50.7% of those who underwent only BAL. The rate of recovery after BAL was significantly lower in the group with any complications who underwent only BAL, and the cutoff value was 29%. Hypoxemia was the most prevalent complication and %VC was significantly lower in the group with hypoxemia. Compared with the background features of patients with idiopathic interstitial pneumonia, CRP levels were significantly higher and the rate of recovery after BAL was lower among patients with fever. Marked neutrophilia was evident in BAL fluid, and the rate of recovery after BAL was also low in hypoxemic patients. Conclusion. Although BAL is a relatively safe procedure, about half of all patients develop complications such as hypoxemia and fever. Therefore, written informed consent to undergo BAL must be obtained in advance. Complications might have tended to arise due to low %VC values. The low recovery rates after BAL and the significant amount of neutrophilia in BAL fluid indicate that patients should be closely monitored during and after the procedure.
