Bronchial collapse during bronchoalveolar lavage in horses is an indicator of lung inflammation.
Authors: Koblinger K, Hecker K, Nicol J, Wasko A, Fernandez N, Léguillette R
Journal: Equine veterinary journal
Summary
# Editorial Summary: Bronchial Collapse During BAL as an Indicator of Lung Inflammation Bronchial collapse during bronchoalveolar lavage (BAL) may reflect the presence and severity of lower airway inflammation, but this relationship had not been systematically evaluated in field conditions. Koblinger and colleagues prospectively graded bronchial collapse (using a simple 0–2 scoring system) in 131 horses undergoing standardised BAL procedures, then correlated collapse severity with cytological findings of airway inflammation and fluid recovery volumes. Severe bronchial collapse (score 2) was associated with a 95% positive predictive value for detecting either mild/moderate or severe inflammation, with horses exhibiting collapse scores of 2 recovering significantly less fluid than those with partial or no collapse—a reduction linked to increased neutrophilia in the recovered sample. For practitioners, this means observing pronounced airway collapse during BAL can serve as a clinical indicator of significant lower airway disease, whilst the mechanism likely involves inflammation-driven changes in airway wall compliance that contribute to dynamic compression during aspiration. Understanding this relationship may refine interpretation of BAL findings and help clinicians better assess the inflammatory status of horses presenting with respiratory symptoms.
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Practical Takeaways
- •Observe for bronchial collapse during BAL procedures in your horses—it is a reliable clinical indicator of lung inflammation and should prompt further diagnostic consideration
- •Expect reduced fluid recovery from BAL in horses with significant airway collapse, which may affect diagnostic yield and interpretation
- •Bronchial collapse during BAL suggests underlying airway inflammation; clinicians should correlate findings with clinical signs and consider anti-inflammatory management strategies
Key Findings
- •Bronchial collapse scores (0, 1, or 2) differed significantly across BAL inflammation categories (P<0.001), with 28% no collapse, 42% partial collapse, and 30% severe collapse
- •Severe bronchial collapse (score 2) had a positive predictive value of 0.95 for both mild/moderate and severe lower airway inflammation
- •BAL fluid return volume was significantly lower in horses with severe collapse compared to partial or no collapse groups (P<0.001)
- •BAL fluid volume was negatively correlated with neutrophil percentage (P<0.001), indicating inflammation severity