Bronchoalveolar Lavage (BAL) on Bronchoscopy BRONCHOALVEOLAR LAVAGE is a technique used in bronchoscopy for several diagnostic purposes. For example, if there is concern for an infectious process in the right middle lobe, the scope can be wedged in one of the segments in the right middle lobe and a BAL can be done. The bronchoscope is directed into a smaller airway of concern (guided by chest imaging), and it is “wedged” into the small airway. A proper wedge is noted when the airway collapses when suction is applied. Once wedged, sterile normal saline is inserted into a subsegment of the lung, followed by suction and collection of the instillation for analysis. This simple procedure can help a pulmonologist in several ways as noted below! — Infection — Diagnosing sarcoidosis — Diffuse Alveolar Hemorrhage (DAH) — Pulmonary Alveolar Proteinosis (PAP) — Eosinophilic Pneumonia — Hypersensitivity Pneumonitis (HP) — Some (but often not helpful) Interstitial Lung Diseases (ILDs) — and even occupational exposures! This is a video of a bronchoscope wedged into a subsegment of the lung with instillation of saline for the BAL. Dr. Komal Parikh @pulmcritdoc #Bronchoalveolar #Lavage #BAL #Bronchoscopy #clinical #video #pulmonary
