Acute respiratory failure in immunocompromised patient: When the broncho-alveolar lavage is wained?

Abstract

Acute respiratory distress is frequent and severe in immunocompromised patients. Diagnosis of the etiology is essential to improve survival. This etiological diagnosis is difficult because of the multiplicity of causes and the severity of the patients. Although recommended for many years, fibroscopy and bronchoalveolar lavage are not mandatory for the diagnosis of all etiologies. Many of these diagnoses can be made using non-invasive tests currently available.

The choice of diagnostic strategy is based on diagnostic hypotheses derived from clinico-radiological analysis. This review assesses the value of different diagnostic strategies, including or excluding BAL. In particular, the method for formulating hypotheses to guide the diagnostic strategy is developed to help the reader in the management of these particular patients.