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Bronchoalveolar lavage cellularity in healthy children
1Department of Thoracic Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
Summary
This study establishes a standardized bronchoalveolar lavage (BAL) protocol for children, providing crucial reference values for healthy pediatric patients. The findings confirm BAL
Area of Science:
- Pediatric Pulmonology
- Clinical Immunology
- Respiratory Medicine
Background:
- Bronchoalveolar lavage (BAL) is an important diagnostic tool, but its application in pediatric patients lacks standardized protocols.
- Establishing reference values for BAL fluid analysis in children is essential for accurate diagnosis and management.
Purpose of the Study:
- To evaluate a standardized protocol for obtaining, processing, and analyzing BAL fluid in children.
- To establish reference values for BAL cellular and protein content in healthy pediatric subjects.
Main Methods:
- A standardized protocol involving flexible bronchoscopy and sequential aliquots of saline was used in 18 healthy children (3 months to 10 years).
- BAL fluid was processed with the first aliquot analyzed separately and the subsequent two pooled.
- Cellular counts and differential analysis were performed, including T-cell subset ratios.
Main Results:
- The first aliquot showed higher neutrophil and epithelial cell percentages.
- Pooled BAL fluid in healthy children yielded median cell counts of 155 x 10(3)/ml, with macrophages comprising 91%.
- Lymphocyte subsets showed some differences compared to adults, but overall cellular values were comparable.
Conclusions:
- A standardized BAL protocol is feasible and appropriate for pediatric use.
- The study provides essential reference values for BAL fluid analysis in healthy children.
- Findings support the utility of BAL in pediatric respiratory diagnostics.