Objective: A noninvasive bronchoscopic microsampling (BMS) probe was developed to sample biochemical constituents of the epithelial lining fluid in small airways. Design: Observational, controlled study. Setting: Intensive care unit of academic medical center. Patients and Procedure: BMS was applied in a control group of seven patients who had hemoptysis or small solitary peripheral nodules but no hypoxemia or other signs of acute inflammation and in four patients with acute respiratory distress syndrome (ARDS), to test whether BMS can ascertain the presence of acute pulmonary inflammation without complications. Measurements and Results: Complications, including a significant decrease in arterial oxygen saturation, were observed neither during nor after BUS. In the ARDS group, albumin, lactate dehydrogenase, interleukin-6, basic fibroblast growth factor, and neutrophil elastase concentrations in epithelial lining fluid were significantly higher (p < .0001, p = .012, p < .0001, p < .0001, and p < .0001, respectively) than in the control group. Serial BMS was safely performed in one patient with ARDS, allowing us to observe a correlation between changes in the concentration of inflammation-related biochemical markers and clinical course of the disease. Conclusions: These results suggest that BMS is safe and useful to monitor pulmonary biochemical events in ARDS.
- Acute inflammatory lung injury
- Acute respiratory distress syndrome
- Bronchoalveolar lavage
- Bronchoscopic microsampling
- Epithelial lining fluid
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine