title: [Application of bronchoalveolar lavage treatment via bronchoscopy in the management of accidental inhalation of liquid and powdery foreign bodies in children].
abstract: OBJECTIVE
  To evaluate the effect of bronchoalveolar lavage (BAL) through bronchoscopy in diagnosis and treatment of accidental inhalation of liquid and powdery foreign bodies in children.
  
  
  METHODS
  Twenty-one cases of accidental inhalation were classified into the following 4 groups according to the materials inhaled: 3 cases inhaled the lipidic material; 2 cases inhaled chemical material; 15 cases inhaled hydrosoluble materials; 1 case inhaled powdery material. Eighteen cases were hospitalized within 3 days after the accidents, which included 16 cases treated within 1 day in hospital. And 3 cases were hospitalized 3 days after the accident. After hospitalization, all patients were immediately treated with direct aspiration and lavage clearance method through bronchoscopy. The inhaled foreign materials were cleared as soon as possible, which reduced the absorption, stimulation and infection of respiratory mucosa. The therapeutic effect was evaluated by endoscopic findings, clinical manifestation, laboratory examination and chest imaging. At the same time, decision was made on the second BAL and the prognosis was estimated.
  
  
  RESULTS
  Twenty-one cases had dyspnea of certain degree. The bronchial mucous membrane of all the 21 cases showed hyperemia, edema and exudate attached. Lavage fluid looked like broth and contained much of the inhaled material. After two to five times treatment, 18 cases were cured (86%), but 3 cases died (14%). One of these 3 cases fell into an oil well, 1 into mosquito repellent solution, another into manure pit. The patients who could not survive had severe airway obstruction, which was difficult to clean and made the problem deteriorated progressively. One of the patients was sent to a hospital 3 days after the accident and another case developed fungal infection, pneumothorax and finally respiratory failure.
  
  
  CONCLUSIONS
  BAL through bronchoscopy is necessary for children who accidentally inhaled liquid and powdery materials. This treatment is safe and effective in diagnosis and treatment of such problems in children. The effect of treatment is influenced by types of inhaled material, the time of lavage clearance through bronchoscopy, and certain complications, such as infection etc.
authors.affiliation: Center for Respiratory Intervention, Qilu Children's Hospital, Shandong University, Ji'nan 250022, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Liu
authors.forename: Cai-yun
authors.initials: CY
authors.lastname: Ni
authors.forename: Huai-lian
authors.initials: HL
authors.lastname: Wang
authors.forename: Zhong-xiao
authors.initials: ZX
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Ma
authors.forename: Xiu-li
authors.initials: XL
authors.lastname: Yan
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Xiao
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.forename: Xiao-rong
authors.initials: XR
authors.lastname: Han
authors.forename: Chen
authors.initials: C
authors.lastname: Meng
mesh_terms: D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000628:therapy*; D006801:Humans; D007223:Infant; D019570:Inhalation Exposure; D008297:Male; D011208:Powders
chemical_list: D011208:Powders