Validation of therapeutic bronchoscopic bronchial washing in cystic fibrosis.

Validation of rigid-tube bronchoscopy with small-volume (5-ml increments not to exceed 300 
ml) bronchial washing as a therapeutic adjunct was performed on six 
patients with cystic fibrosis, using serial tests of pulmonary function as 
a yardstick for assessment of efficacy. Two patients did not undergo 
the procedure and served as control subjects. All patients were characterized 
as having varying severity of pulmonary involvement. Large central airways were 
severely obstructed, and older patients had more trapped gas in their 
lungs. Hypoxemia and large alveolar-arterial oxygen pressure differences [P(A-a)O2] were due 
to inhomogeneity of alveolar ventilation. Results indicated that up to ten 
days to two weeks, bronchoscopic bronchial washing may in some instances 
improve maximal expiratory flow-volume curves and specific airway conductance and decrease 
P(A-a)O2 towards normal. Distribution of alveolar gas P(A- a)O2 towards normal. 
Distribution of alveolar gas became more homogeneous. We conclude that bronchoscopic 
bronchial washing may be effective in the management of patients with 
cystic fibrosis, by augmentation of their inadequate cleansing function of the 
conducting airways. 