Bronchoalveolar Lavage (BAL) in Adult Respiratory Distress Syndrome (ARDS)
Adult respiratory distress syndrome (ARDS) is a complex pulmonary dysfunction of varied etiology, often affecting young and previously healthy individuals. It is associated with a very high mortality which remains unchanged since first described in 1967 . Although various factors are involved, the final outcome is a sequence of common pathologic findings including pulmonary edema and hemorrhage, hyaline membrane formation, micro- and macrothrombi, inflammatory cell deposits and fibrosis. Based on human studies and experimental models of ARDS, several possible mechanisms of acute lung injury have been proposed . Bronchoalveolar lavage (BAL) is a useful and safe “liquid lung biopsy” to study the alveolar fluid in many respiratory diseases [3–5]. BAL fluid does not represent a simple diluted sample of plasma but rather reflects a selective metabolic activity of the inflamed pulmonary interstitium and alveoli. In this way, many authors have assessed BAL fluid analysis to study many mediators that could have a true effect in the ARDS pathogenesis . The main fields that have been studied by means of BAL fluid analysis in ARDS are the following:
KeywordsAngiotensin Converting Enzyme Acute Lung Injury Alveolar Macrophage Idiopathic Pulmonary Fibrosis Bronchoalveolar Lavage
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