Kamel T, Helms J, Janssen-Langenstein R, et al. - Researchers performed this study with intensive care unit (ICU) patients, to evaluate the benefit-to-risk balance of bronchoalveolar lavage (BAL) in this population. Participating ICUs were 16 in number. Adverse events during or within 24 h following BAL were prospectively obtained, and experts evaluated the BAL input for decision making in consecutive adult patients. This study included 483 BAL in 483 patients. Findings revealed that adverse events associated with BAL were not infrequent nor certainly benign in ICU patients. In non-intubated patients, poor BAL tolerance was mainly predicted by a BAL performed by a non-experienced physician (non-pulmonologist, or intensivist with less than 10 years in the specialty or less than 50 BAL performed), as revealed on logistic regression. Based on these findings, extreme caution is required when envisaging a BAL in ICU patients and for a necessary accompaniment of the less experienced physicians.