Hemodynamic Response of the Pulmonary Circulation to Bronchopulmonary Lavage in Man

During 16 bronchopulmonary lavages on nine patients, only mild hypoxemia developed. Since blood perfusing the liquid-filled lung is not exposed to alveolar gas, this suggests decreased perfusion of the lavaged lung. During four lavages, the degree of perfusion of the lavaged lung was shown to increase with the difference between the pressure in the pulmonary artery and the hydrostatic pressure of fluid filling the lavaged lung. To increase the safety of bronchopulmonary lavage, one should use high concentrations of inspired oxygen, maintain airway pressure of the lavaged lung above or as close as possible to pulmonary-artery pressure, and closely monitor arterial-blood gases.