title: Effects of different bronchoalveolar lavage methods on tracheobronchial foreign body patients.
abstract: OBJECTIVE
  To compare the different effects of bronchoalveolar lavage (BAL) with diverse combinations of lidocaine, epinephrine, and dexamethasone on pediatric patients with an inhaled tracheobronchial foreign body (TFB).
  
  
  METHODS
  Randomized controlled study.
  
  
  METHODS
  Two hundred forty cases of pediatric patients with inhaled TFB were included in this study, and were randomly divided into four groups using three kinds of drugs for BAL, namely 0.9% saline (S) group, 2% lidocaine with diluted epinephrine (LE) group, 2% lidocaine with diluted epinephrine and 0.5% dexamethasone (LED), control group (C) without BAL. The incidences of intraoperative or postoperative complications and recovery periods were compared. Meanwhile, the concentrations of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α in BAL fluids and plasma were evaluated by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The incidences of bronchospasm, hypoxemia, and postoperative fever were significantly lower in the LED group than other groups (P < .001). Fever after the TFB removal procedure appeared later in the LED group than the other groups. The improvement and healing periods in the LE and LED groups were significantly shorter than those in the C and S groups (P < .001). The concentrations of IL-1β, IL-6, and TNF-α in BAL fluids were significantly higher in the LE and LED groups than those in the S group (P < .001), but those in the plasma of the C and S groups were lower compared with the LE and LED groups (P < .001).
  
  
  CONCLUSIONS
  BAL with lidocaine, epinephrine, and dexamethasone could promote recovery for TFB patients and reduce incidences of complications, possibly by regulating release of proinflammatory cytokines.
  
  
  METHODS
  1b.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Hua-Nan
authors.initials: HN
authors.lastname: Luo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Si-Jing
authors.initials: SJ
authors.lastname: Ma
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Hai-Li
authors.initials: HL
authors.lastname: Guo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Zheng-Hui
authors.initials: ZH
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Xiao-Yong
authors.initials: XY
authors.lastname: Ren
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D018893:Bronchoalveolar Lavage / Q000379:methods*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005547:Foreign Bodies / Q000628:therapy*; D006801:Humans; D015994:Incidence; D053583:Interleukin-1beta / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D007431:Intraoperative Complications / Q000453:epidemiology; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D001993:Bronchodilator Agents; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D003907:Dexamethasone; D008012:Lidocaine; D004837:Epinephrine
keywords: Tracheobronchial foreign body; bronchoalveolar lavage; dexamethasone; epinephrine; lidocaine