Lecture 13 Flashcards
Tracheal wash- how invasive?
What are you sampling?
Minimally invasive
Samples fluid and cells from trachea and primary bronchi
What technique do small dogs and cats receive for tracheal washes?
Large dogs?
Endotracheal wash
Transtracheal wash
What are indications that you should do a tracheal wash?
Large airway disease Persistent cough Wheezing Radiographic evidence of respiratory disease Bacterial pneumonia
Do you need anesthesia for tracheal wash?
No!
Contraindications for transtracheal wash
Fractious/uncooperative
Hypocoaguable/ throbocytopenic patients
Patients with severe skin disease
Side effects of transtracheal wash
Transient worsening of respiratory status
Airway irritation and bronchoconstriction
Subcutaneous emphysema and pneumomediastinum
Do you need anesthesia for endotracheal wash?
Yes!
Difference between tracheal wash and BAL
Tracheal wash collects material from large airways
BAL collects material from deep within lung (alveoli)
How do you know you have a good sample from BAL?
Layer of foam on top of fluid (indicates surfactant)
Describe BAL
Requires anesthesia
Detects diseases of small airways and alveoli
Two techniques- bronchoscopy guided; endotracheal
When is BAL indicated?
Patients without resp distress
Small airway lung disease
Used in combination with bronchoscopy
How should samples be handled?
Quickly! Need to make slides yourself
What are significant findings in samples?
Increased neutrophils or eosinophils
Pathogens inside phagocytes
Parasitic ova, larval fungus, neoplastic cells
What should you culture?
Definitely aerobes minimally
Not anaerobes usually
Mycoplasma and fungi in chronic diseases
Is it normal to find bacteria in your samples?
Yes! As long as they are low numbers
