Effect of Lavage Solution Type on Bronchoalveolar Lavage Fluid Cytology in Clinically Healthy Horses

Equine bronchoalveolar lavage (BAL) is usually performed with 250-500 mL of isotonic saline at pH 5.5. The acidic pH of saline may cause an increase in airway neutrophil count 48 h after BAL. Other isotonic solutions such as Ringer's solution, phosphate-buffered saline (PBS) or Plasma-Lyte 148((R)) have a neutral pH of 7.4 and might be a better choice for BAL by not provoking inflammation and the influx of neutrophils into airways. BAL was performed in four healthy horses in four different lung lobes using four different solutions in a randomized crossover design. In each lobe, BAL was performed twice with a 48 h interval using 250 mL of solution. Automated total nucleated cell counts (TNCs) were recorded, and differential cell counts in lavage fluid were determined by two investigators blinded to treatments. The mean volume of BAL fluid retrieved was 51 +/- 14%. The mean neutrophil percentage (%N) increased from 1.5 +/- 0.9% to 14.7 +/- 9.6% at 48 h (p < 0.001) but was not significantly affected by the solution used or the lung lobe sampled. In conclusion, in this study, the influx of neutrophils into airways after BAL was independent of the type of isotonic solution used and the lung lobe sampled. Saline remains an appropriate solution for BAL in horses.

Automated summary

Equine bronchoalveolar lavage (BAL) is commonly performed with isotonic saline, but the acidic pH of saline may increase airway neutrophil count. This study compared the effects of different isotonic solutions on neutrophil influx after BAL in horses and found that the type of solution used and the lung lobe sampled did not significantly affect neutrophil percentage in the lavage fluid. Saline remains an appropriate choice for BAL in horses.