Nationwide Questionnaire-based Survey on Methods for Performing Bronchoalveolar Lavage

Background: Although bronchoalveolar lavage (BAL) is widely used in clinical practice in Japan, the methods of saline injection and BAL sample analysis differ among institutions.Materials and Methods: We conducted a questionnaire survey at 915 facilities accredited by the Japan Respiratory Society to examine the differences in the implementation methods of BAL among facilities. During the survey period from May 15, 2019, to July 30, 2019, we received responses from 442 facilities (48.3%).Results: A total of 364 facilities (86.5%) reported that BAL was performed in less than 30% of bronchoscopy procedures. The saline volume used in BAL was 50 mL× 3 times at 377 facilities (90.7%). At 380 facilities (88.6%), BAL was performed on sites with strong imaging lesions. Overall, 244 facilities (56.9%) did not perform BAL for acute exacerbation of interstitial pneumonia.Conclusions: As each aspect of the BAL procedure was found to differ across facilities, standardization of the BAL procedures is desirable.