The blind BAL performed with wedge pressure catheter was most accurate at ≥ 103 cfu /ml (kappa 0.78) in the present study. Pugin et al (18) compared blind BAL results with bronchoscopic BAL. They calculated a sensitivity of 73% and a specificity of 96% and PPV of 92% for blind non-bronchoscopic BAL. Gaussorgues etal (34) used 7 Fr right heart catheterization cuffed catheter for blind BAL in 13 adults and compared with postmortem lung tissue histology and culture. When lung histology and cultures were negative for pneumonia and organisms, the blind BAL were also negative for organisms on culture. Among the 10 positive blind- BAL cultures, lung biopsy showed histologic pneumonia in 9 cases. Fourteen organisms were cultured from lung tissue while blind BAL correctly identified the causative microbes in 13 cases. Alpert etal (35) used 4 Fr balloon tipped wedged pressure catheter to perform blind BAL in 20 pediatric cases aged 1 month to 6.5 years. Clinically significant information was obtained in 17 (85%) cases and no patients required an open lung biopsy. Other innovative method for blind BAL using feeding tube in small children has been described by Koumbourlis etal (36).