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Bronchoalveolar Lavage (BAL) for Research; Obtaining Adequate Sample Yield
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Bronchoalveolar Lavage (BAL) for Research; Obtaining Adequate Sample Yield

Published on: March 24, 2014

Risk factors for multiple bronchoalveolar lavage procedures in children with severe or refractory Mycoplasma

Chaolei Yang1, Guitao Li2, Ying Zhu2

  • 1Fuyang Normal University, Fuyang Medical College, Fuyang, Anhui, PR China.

Jornal De Pediatria
|May 18, 2026
PubMed
Abstract

Insights

Mucus plugs and elevated CRP, LDH, and D-dimer levels indicate a higher need for repeated bronchoalveolar lavage (BAL) in children with severe Mycoplasma pneumoniae pneumonia (MPP). Early intervention can prevent complications from multiple BAL procedures.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Severe or refractory Mycoplasma pneumoniae pneumonia (MPP) in children can necessitate repeated interventions.
  • Bronchoalveolar lavage (BAL) is a diagnostic and therapeutic procedure used in pediatric respiratory illnesses.
  • Understanding factors leading to multiple BAL procedures is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

  • To identify clinical and laboratory factors associated with the frequency of bronchoalveolar lavage (BAL) in children with severe or refractory Mycoplasma pneumoniae pneumonia (MPP).
  • To provide evidence-based guidance for early intervention strategies in pediatric MPP cases requiring multiple BAL procedures.

Main Methods:

  • Retrospective analysis of clinical data from 271 children with severe or refractory MPP who underwent BAL.
  • Patients were categorized into single-treatment (STG) and multiple-treatment (MTG, ≥2 BALs) groups.
  • Logistic regression and receiver-operating characteristic (ROC) curve analyses were employed to identify risk factors for multiple BAL procedures.

Main Results:

  • The multiple-treatment group (MTG) exhibited higher peak body temperatures, longer fever duration, and more frequent pulmonary consolidation, pleural effusion, atelectasis, mucus plug formation, and multi-lobar involvement compared to the single-treatment group (STG).
  • Elevated white blood cell count, neutrophil percentage, C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, and D-dimer levels, along with lower lymphocyte percentage, were observed in the MTG.
  • Independent risk factors for multiple BAL identified by logistic regression and ROC analyses included mucus plug formation, CRP ≥ 25.68 mg/L, LDH ≥ 374.90 U/L, and D-dimer ≥ 1.22 mg/L.

Conclusions:

  • Mucus plug formation and elevated levels of CRP, LDH, and D-dimer are significant predictors of requiring multiple bronchoalveolar lavage procedures in children with severe or refractory MPP.
  • Pediatricians should enhance management and implement early interventions for children with these risk factors to mitigate potential harm associated with repeated BAL procedures.
Keywords:
Bronchoalveolar lavageBronchoscopyChildrenMycoplasma pneumoniae pneumonia

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