Risk factors for disease-related deterioration following diagnostic bronchoalveolar lavage procedures in diffuse lung disease: a case-control study

PeerJ

article

Yuko Usagawa¹  Kosaku Komiya¹  Mari Yamasue¹  Kazuhiko Hashinaga¹  Eri Mizukami¹  Kenji Umeki¹  Shin-ichi Nureki¹  Masaru Ando¹  Kazufumi Hiramatsu²  Jun-ichi Kadota¹ 

[1] Department of Respiratory Medicine and Infectious Diseases, Oita University;Department of Medical Safety Management, Oita University

关键词: Bronchoalveolar lavage;    Acute exacerbation;    Diffuse lung disease;    Idiopathic pulmonary fibrosis;    Eosinophilic pneumonia;   

DOI  :  10.7717/peerj.9864

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundAlthough the risk factors for diagnostic bronchoalveolar lavage (BAL)-induced acute exacerbations in patients with idiopathic pulmonary fibrosis (IPF) have been previously reported, no study has assessed these in patients with non-IPF. We aimed to identify the risk factors for BAL-induced disease deterioration (BAL-DD) in all types of diffuse lung disease.MethodsPatients with diffuse lung disease who underwent BAL at our hospital from April 2012 to November 2017 were retrospectively analyzed. The patient information, laboratory data, radiological findings, and BAL fluid analysis results in patients who developed BAL-DDs were compared with those in patients who did not.ResultsBAL-DDs occurred in 14 (3.3%) of the 429 patients included the study. The BAL-DD group had a significantly poorer performance status, higher C-reactive protein level, lower partial pressure of oxygen in the arterial blood at rest, greater proportion of desaturation on exertion and cases having followed a progressive clinical course before BAL, and more extensive consolidation and ground-glass opacity on chest high-resolution computed tomography (HRCT) than the non-BAL-DD group. A high total cell concentration and an increased number of eosinophils in the BAL fluid were more frequently found in patients with BAL-DD than in those without.ConclusionsPatients with decreased physical activity level, increased level of inflammatory markers, low oxygenation status, and extensive lung involvements on chest HRCT and following a progressive clinical course before BAL may be warned of the BAL-DD risk. Elevated eosinophil counts in the BAL fluid could be associated with the triggering of BAL-DDs.

【 授权许可】

CC BY