ArticleIntensive care medicine2020
Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study.
Article in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04502368 (Fiberoptic Bronchoscopy and Bronchoalveolar Lavage in Critically Ill Ventilated Patients), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Fiberoptic Bronchoscopy and Bronchoalveolar Lavage in Critically Ill Ventilated Patients: Impact on Respiratory Mechanics and Gas Exchange
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care.BMC pulmonary medicine · 2021Pooled it
- Flexible Bronchoscopy in the Intensive Care Unit: Controversies, Clinical Applications, and the Expanding Role of Intensivists.Journal of clinical medicine · 2026Review
- CAP in the ICU: are they all in fact CAP?Intensive care medicine · 2026Article
- Bronchoalveolar lavage during prone positioning in patients with severe acute respiratory distress syndrome: safety concerns.Critical care (London, England) · 2026Article
- High-flow nasal oxygen therapy via a single-prong cannula interface during bronchoscopy in patients with acute respiratory failure: a two-center, open-label, randomized controlled trial.Annals of intensive care · 2026Article
- Should bronchoscopic lavage after pulmonary aspiration be routinely offered?AME case reports · 2026Article
- Non-invasive molecular surveillance of drug-resistant bacterial and fungal pathogens in severe ICU pneumonia: a comparative study of nasopharyngeal swabs and BALF.Frontiers in microbiology · 2026Article
- Choosing wisely: comparing the carbon footprint of three respiratory sampling techniques for ventilator-associated pneumonia.Annals of intensive care · 2025Article
- Cytomegalovirus reactivation in the lower respiratory tract as an independent risk factor for mortality in critically Ill patients.Critical care (London, England) · 2025Article
- A comprehensive evaluation of murine and humanERJ open research · 2025Article
- Towards a holistic approach to pulmonary infections. Insights from the Sixth Annual Meeting of Spanish Experts 2024.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Single-use vs. reusable flexible bronchoscopes for airway management and in critical care: a narrative review.Anaesthesia · 2025Review
- Effect of ciprofol compared with propofol on hemodynamics in bronchoscope procedures during anesthetic induction: a randomized double-blind controlled study.Frontiers in medicine · 2025Article
- Precision Medicine in Acute Respiratory Distress Syndrome: Progress, Challenges, and the Road ahead.Clinics in chest medicine · 2024Review
- Efficacy and safety of remimazolam in bronchoscopic sedation: A meta-analysis.World journal of clinical cases · 2024Article
- Combining high-flow nasal cannula oxygen therapy with repeated toilet bronchoscopies for respiratory failure due to excessive infected airway secretions: a case report and series from a non-intensive hospital ward.Frontiers in medicine · 2024Article
- Research Bronchoscopies in Critically Ill Research Participants: An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2023Article
- Timing of bronchoscopy and application of scoring tools in children with severe pneumonia.Italian journal of pediatrics · 2023Article
- Ventilator-Associated Pneumonia in Immunosuppressed Patients.Antibiotics (Basel, Switzerland) · 2023Review
- Temporal Trends and Variation in Bronchoscopy Use for Acute Respiratory Failure in the United States.Chest · 2023Observational
Corrections and comments
- Commented on byAuthor's reply.2022
Authors and funding
19 authors at 15 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the benefit-to-risk balance of bronchoalveolar lavage (BAL) in intensive care unit (ICU) patients.
methodsIn 16 ICUs, we prospectively collected adverse events during or within 24 h after BAL and assessed the BAL input for decision making in consecutive adult patients. The occurrence of a clinical adverse event at least of grade 3, i.e., sufficiently severe to need therapeutic action(s), including modification(s) in respiratory support, defined poor BAL tolerance. The BAL input for decision making was declared satisfactory if it allowed to interrupt or initiate one or several treatments.
resultsWe included 483 BAL in 483 patients [age 63 years (interquartile range (IQR) 53-72); female gender: 162 (33.5%); simplified acute physiology score II: 48 (IQR 37-61); immunosuppression 244 (50.5%)]. BAL was begun in non-intubated patients in 105 (21.7%) cases. Sixty-seven (13.9%) patients reached the grade 3 of adverse event or higher. Logistic regression showed that a BAL performed by a non-experienced physician (non-pulmonologist, or intensivist with less than 10 years in the specialty or less than 50 BAL performed) was the main predictor of poor BAL tolerance in non-intubated patients [OR: 3.57 (95% confidence interval 1.04-12.35); P = 0.04]. A satisfactory BAL input for decision making was observed in 227 (47.0%) cases and was not predictable using logistic regression.
conclusionsAdverse events related to BAL in ICU patients are not infrequent nor necessarily benign. Our findings call for an extreme caution, when envisaging a BAL in ICU patients and for a mandatory accompaniment of the less experienced physicians.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.