Bronchoalveolar lavage in the treatment of severe bronchopulmonary pathology in newborns and infants (literature review)

• Evgeniy Yu. Bonitenko
• Artem A. Burov
• Sergey A. Vasiliev
• Natalia A. Belyakova
• Victor V. Zubkov
• Gennady T. Sukhikh

Abstract

One of the methods widely used by specialists for the diagnosis and treatment of severe bronchopulmonary pathology in newborns and infants is bronchoalveolar lavage (BAL). The use of the BAL for diagnostic purposes is currently beyond doubt. Its therapeutic value in the literature is represented by isolated reports. It should also be noted that despite the widespread use of the therapeutic BAL in clinical practice in newborns and infants, the indications and contraindications for this procedure have not only not been regulated yet but have not even been fully defined.

Purpose of the study. Based on the analysis of literature data, to determine the indications and contraindications for therapeutic BAL in newborns, premature infants, and infants, and also to establish its possible classification features.

Results. Based on the analysis of available literature data, indications and contraindications for therapeutic BAL were systematized for neonatal patients and infants; the classification features of therapeutic BAL were identified in order to unify the design of standard operating procedures within a single conceptual field. The manifestations and causes of the development of complications and adverse reactions that occur during therapeutic BAL were determined and systematized. It was found that, despite the large number of available scientific publications and the usage of BAL for therapeutic purposes in clinical practice in newborns and infants, a number of issues, such as indications, contraindications, and methods for conducting procedures. Nevertheless, they remain poorly studied. The fact that the issues related to the conduct of BAL are interdisciplinary in nature and the junction of the competencies of doctors of various specialties: anesthesiology, neonatology, pediatric pulmonology, and specialists in endoscopy.

The procedures for therapeutic BAL in neonatology in relation to the preventive and therapeutic use of surfactant preparations are regulated and presented in the form of standard operating procedures. All other options are currently under development.

Conclusion. To solve existing problems, it is necessary to conduct systematic research in this direction with the involvement of all interested specialists and the definition of roles.

Keywords:bronchoalveolar lavage; indications; contraindications; classification; bronchopulmonary pathology; premature newborns;, newborns; infants

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