Transtracheal wash and bronchoalveolar lavage.

Examination and sampling of the pulmonary airways can be of great benefit in patients with respiratory disease. Transtracheal and endotracheal washes are minimally invasive procedures that allow for blind sampling of the larger airways for cytologic and culture analysis. Flexible tracheobronchoscopy allows for direct visualization of the trachea, bronchi, and oropharynx. Bronchoalveolar lavage helps to obtain samples from the small airways and alveoli during bronchoscopy. The combined use of these techniques can help clinicians diagnose challenging respiratory cases. The following article reviews the indications and techniques of these procedures.