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BackgroundBronchoalveolar lavage (BAL) is a standardized method to obtain specimen samples from the airway lumen of the respiratory system. BAL is used to diagnose lung infection and infection markers in neonates.ObjectivesThe aim was to evaluate the utility of flexible fiberoptic bronchoscopy in term and preterm neonates and to evaluate the use of BAL obtained by bronchoscopy in neonatal lung disease.MethodsA retrospective analysis of Neonatal Intensive Care Unit (NICU) babies, during a 7-year period was conducted on 599 neonates who underwent the BAL procedure. Characteristics of the patients, indications, complications, and results of the procedure were recorded.ResultsThe main indications were nosocomial pneumonia (140) and unilateral lung disease (74). A normal finding was most prevalent (201), followed by tracheitis (65). Microbiology on BAL fluid was positive in 33% of bronchoscopies (195/599); most common organisms isolated were Acinetobacter, Klebsiella, and Pseudomonas.ConclusionsNeonatal bronchoscopy can serve as an important diagnostic and therapeutic tool in the management of neonatal lung disease, BAL specimen microbiology from bronchoscopy directs clinical decision making in the management of neonatal lung infection. Individual common markers of infection have poor correlation to BAL. A combination of the markers, however, improves correlation with BAL but their utility in clinical management of lung infection is subject to caution. A negative BAL may shift management emphasis on minimizing lung injury especially in neonates who are ventilator dependent; BAL has the potential to critically affect the management of babies with significant lung disease especially when ventilator dependent.

Original publication





Pediatric pulmonology

Publication Date





415 - 420


Neonatal Intensive Care Unit-Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, South Africa.


Bronchoalveolar Lavage Fluid, Humans, Bacteria, Respiratory Tract Diseases, Bronchoscopy, Retrospective Studies, Bronchoalveolar Lavage, Infant, Newborn, Intensive Care Units, Neonatal, Female, Male