BAL has been used since 1988 in the diagnosis of ventilator-associated
pneumonia (VAP). Quantitative cultures retrieved by protected and
nonprotected bronchoscopic BAL have been reported to be accurate for
the diagnosis of this frequent complication of mechanical ventilation.
This section covers BAL methods that utilize fiberoptic bronchoscopy.
We reviewed 23 studies evaluating the accuracy of BAL methods using
fiberoptic bronchoscopy to diagnose VAP in a total of 957 patients. The
number of reported VAP episodes was 431. Most reported studies are case
series, although five immediate postmortem studies have been described