BACKGROUND: Bronchoscopic bronchoalveolar lavage in children to investigate bronchial disorders such as asthma has both ethical and procedural difficulties. OBJECTIVE: The aim of this study was to establish a standardized non-bronchoscopic method to perform bronchoalveolar lavage in children attending for elective surgery to obtain normal cellular data. METHODS: Bronchoalveolar lavage was performed on normal children (n = 55) by infusing saline (20 mL) through an 8 FG suction catheter passed after endotracheal intubation. Oxygen saturation, heart and respiratory rate were monitored during the bronchoalveolar lavage procedure. Cellular analysis and total protein estimation of the lavage fluid were performed. Epithelial lining fluid volume was calculated (n = 15) using the urea dilution method. RESULTS: The procedure was well tolerated by all children. Total cell count and differential cell count for children (macrophages 70.8 +/- 2.3%, lymphocytes 3.8 +/- 0.6%, neutrophils 5.7 +/- 1.0%, eosinophils 0.14 +/- 0.03%, epithelial cells 19.6 +/- 2.1%, mast cells 0.21 +/- 0.02%) were similar to those reported for adults. Age and sex comparisons revealed no differences between groups. The mean total protein recovered in the cell free supernatant was 49.72 +/- 4.29 mg/L and epithelial lining fluid volume was 0.82 +/- 0.11% of return lavageate. CONCLUSION: This method allows bronchoalveolar lavage to be performed safely and quickly on children attending for routine elective surgery. Using this method and taking the 'window of opportunity' of elective surgery, the presence or absence of airway inflammation could be studied in children with various patterns of asthma during relatively asymptomatic periods.
BACKGROUND: Bronchoscopic bronchoalveolar lavage in children to investigate bronchial disorders such as asthma has both ethical and procedural difficulties. OBJECTIVE: The aim of this study was to establish a standardized non-bronchoscopic method to perform bronchoalveolar lavage in children attending for elective surgery to obtain normal cellular data. METHODS: Bronchoalveolar lavage was performed on normal children (n = 55) by infusing saline (20 mL) through an 8 FG suction catheter passed after endotracheal intubation. Oxygen saturation, heart and respiratory rate were monitored during the bronchoalveolar lavage procedure. Cellular analysis and total protein estimation of the lavage fluid were performed. Epithelial lining fluid volume was calculated (n = 15) using the urea dilution method. RESULTS: The procedure was well tolerated by all children. Total cell count and differential cell count for children (macrophages 70.8 +/- 2.3%, lymphocytes 3.8 +/- 0.6%, neutrophils 5.7 +/- 1.0%, eosinophils 0.14 +/- 0.03%, epithelial cells 19.6 +/- 2.1%, mast cells 0.21 +/- 0.02%) were similar to those reported for adults. Age and sex comparisons revealed no differences between groups. The mean total protein recovered in the cell free supernatant was 49.72 +/- 4.29 mg/L and epithelial lining fluid volume was 0.82 +/- 0.11% of return lavageate. CONCLUSION: This method allows bronchoalveolar lavage to be performed safely and quickly on children attending for routine elective surgery. Using this method and taking the 'window of opportunity' of elective surgery, the presence or absence of airway inflammation could be studied in children with various patterns of asthma during relatively asymptomatic periods.
Authors: Rémi Villenave; Lindsay Broadbent; Isobel Douglas; Jeremy D Lyons; Peter V Coyle; Michael N Teng; Ralph A Tripp; Liam G Heaney; Michael D Shields; Ultan F Power Journal: J Virol Date: 2015-09-30 Impact factor: 5.103
Authors: W Gerald Teague; Monica G Lawrence; Debbie-Ann T Shirley; Andrea S Garrod; Stephen V Early; Jackie B Payne; Julia A Wisniewski; Peter W Heymann; James J Daniero; John W Steinke; Deborah K Froh; Thomas J Braciale; Michael Ellwood; Drew Harris; Larry Borish Journal: J Allergy Clin Immunol Pract Date: 2019-01-14
Authors: Kavita Pal; Xin Feng; John W Steinke; Marie D Burdick; Yun M Shim; Sun-Sang Sung; W Gerald Teague; Larry Borish Journal: Am J Respir Cell Mol Biol Date: 2019-04 Impact factor: 6.914
Authors: Malcolm G Semple; Hinke M Dankert; Bahram Ebrahimi; Jailson B Correia; J Angela Booth; James P Stewart; Rosalind L Smyth; C Anthony Hart Journal: PLoS One Date: 2007-10-17 Impact factor: 3.240
Authors: Savino Spadaro; Iryna Kozhevnikova; Paolo Casolari; Paolo Ruggeri; Tiziana Bellini; Riccardo Ragazzi; Federica Barbieri; Elisabetta Marangoni; Gaetano Caramori; Carlo Alberto Volta Journal: BMJ Open Respir Res Date: 2017-09-04