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The Heterogeneity of BAL Cells and Protein in Patients at Risk for and With ARDS*

Kenneth P. Steinberg, MD, FCCP; J. Ruzinski; E. Caldwell; F. Radella, II; D. Davis; P. Treece; L. Hudson, MD, FCCP; T. Martin, MD, FCCP
Author and Funding Information

*From the Harborview Medical Center and Seattle Veterans Affairs Medical Center, University of Washington School of Medicine, Seattle, WA.

Correspondence to: Kenneth Steinberg, MD, FCCP, University of Washington School of Medicine, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104-2499



Chest. 1999;116(suppl_1):98S. doi:10.1378/chest.116.suppl_1.98S
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Extract

Initially thought to be a diffuse, symmetric process, it is now known that ARDS can be a radiographically and physiologically patchy, heterogeneous process. BAL has been used extensively to evaluate the inflammatory process in the lungs of patients with ARDS and those at risk for the syndrome. Polymorphonuclear leukocytes (PMNs) and total protein (TP) concentration are increased in BAL in virtually all cases of ARDS, especially in the early phases of lung injury. It is not known to what degree the heterogeneity of ARDS affects the results of BAL. We hypothesized that the inflammatory process was a systemic one and, as such, bilateral BAL would result in relatively equivalent differential cell counts and TP concentration despite the observed radiographic heterogeneity.


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