Current address: Department of Respiratory Medicine. Belfast City Hospital, Lisburn Road, Belfast, UK.
Investigating paediatric airways by non-bronchoscopic lavage: normal cellular data
Article first published online: 27 APR 2006
Clinical & Experimental Allergy
Volume 26, Issue 7, pages 799–806, July 1996
How to Cite
HEANEY, L.G., STEVENSON, E. C., TURNER, G., CADDEN, I.S., TAYLOR, R., SHIELDS, M. D. and ENNIS, M. (1996), Investigating paediatric airways by non-bronchoscopic lavage: normal cellular data. Clinical & Experimental Allergy, 26: 799–806. doi: 10.1111/j.1365-2222.1996.tb00611.x
- Issue published online: 27 APR 2006
- Article first published online: 27 APR 2006
- Submitted 20 March 1995; revised 27 July 1995; accepted 16 February 1996.
- bronchoalveolar lavage fluid;
- mast cells;
- epithelial cells
Background Bronchoscopic bronchoalveolar lavage in children to investigate bronchia disorders such as asthtna 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.