Investigating paediatric airways by non-bronchoscopic lavage: normal cellular data.
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.


CONCLUSIONS
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.
Heaney
L G
LG
Department of Clinical Biochemistry, Queen's University of Belfast, UK.
Stevenson
E C
EC
Turner
G
G
Cadden
I S
IS
Taylor
R
R
Shields
M D
MD
Ennis
M
M
D000293:Adolescent; D000375:Aging / Q000502:physiology; D001826:Body Fluids / Q000378:metabolism; D001980:Bronchi / Q000378:metabolism; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology*; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D004848:Epithelium / Q000378:metabolism; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008297:Male; D008722:Methods; D011506:Proteins / Q000032:analysis; D011650:Pulmonary Alveoli / Q000378:metabolism; D012016:Reference Values; D013396:Suction
D011506:Proteins