Dhillon D P, Haslam P L, Townsend P J, Primett Z, Collins J V, Turner-Warwick M
Eur J Respir Dis. 1986 May;68(5):342-50.
One hundred and seventy patients with interstitial lung diseases undergoing bronchoalveolar lavage (BAL), were contrasted with 51 patients undergoing fibreoptic bronchoscopy alone to define the factors which predispose to post-lavage side-effects. Transient post-bronchoscopy fall in the peak expired flow (PEF) greater than or equal to 20% occurred in both groups (24% and 23% respectively), and thus was probably related to the bronchoscopy procedure. Post-lavage pyrexia (greater than or equal to 1 degree C) occurred only in the patients undergoing BAL (26%), p less than 0.001. Only 4% with pyrexia required antibiotics, and only 2% with falls in PEF needed bronchodilator therapy. The only significant clinical association was more frequent pyrexia in patients on treatment with prednisolone, particularly in women (p less than 0.01). Pyrexia was also associated with higher lavage fluid introduction volumes (greater than 240 ml). Side effects did not relate to the percentages of lavage fluid recovered, although smokers had lower recoveries and, recoveries tended to be higher in sarcoidosis than cryptogenic fibrosing alveolitis. Serial lavages in 25 patients caused no significant increase in side effects.
170例接受支气管肺泡灌洗（BAL）的间质性肺疾病患者与51例仅接受纤维支气管镜检查的患者进行对比，以确定易导致灌洗后副作用的因素。两组患者均出现支气管镜检查后瞬时呼气峰值流速（PEF）下降大于或等于20%（分别为24%和23%），因此这可能与支气管镜检查操作有关。灌洗后发热（大于或等于1℃）仅发生在接受BAL的患者中（26%），p<0.001。仅有4%发热患者需要使用抗生素，仅有2%PEF下降患者需要支气管扩张剂治疗。唯一显著的临床关联是接受泼尼松龙治疗的患者，尤其是女性，发热更为频繁（p<0.01）。发热还与较高的灌洗液体注入量（大于240 ml）有关。副作用与回收的灌洗液体百分比无关，尽管吸烟者回收量较低，结节病患者的回收量往往高于隐源性纤维性肺泡炎患者。25例患者进行的系列灌洗未导致副作用显著增加。
