Technical aspects of bronchoalveolar lavage: recommendations for a standard procedure.

Bronchoalveolar lavage (BAL) has been used widely in the diagnosis of infection. More than 30 years after its description, its use in the clinical management of interstitial lung disease remains controversial. One limitation has been the variations in how the specimen is obtained and handled. Several groups have developed recommendations for obtaining and handling BAL specimens. This article summarizes these recommendations and discusses the variable effects they have on BAL results. The final recommendations provide a standard methodology that can be used by the largest number of pulmonologists.