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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

ZAMORANO W., Alejandra et al. Bronchoalveolar lavage (BAL) in children. Rev. chil. pediatr. [online]. 2002, vol.73, n.6, pp.576-582. ISSN 0370-4106.  http://dx.doi.org/10.4067/S0370-41062002000600003.

Background: BAL could be useful in determining the aetiology and appropriate treatment in children with atypical pneumonias and those with immunosuppression. Objective: Our clinical experience with BAL in the Paedriatric Service of the Catholic University between April 1993 and July 2001 is presented. Patients and Methods: A flexible bronchoscope Olympus 3.6 mm external diameter was used, with a Sony DXC-C1 videocamara. 4 to 6 tubes containing 1cc/kg (maximum 15 ml) of 0.9% saline was used to take samples of secretions from the right middle lobe and lingula if there was diffuse disease or from the affected area in located disease. Samples were sent for bacteriological, viral, TB, fungi and Pneumocystis carinii analysis. Results: 97 BAL were carried out, the results of 82 BAL from 74 patients are analysed. 30/82 were obtained from immunocompromised patients with the following diagnoses: pneumonia 15, interstitial pneumonia 9, pneumonia with atelectasis 3, respiratory distress 3. There were 14 positive cultures (46%) in this group, pathogens 10, CMV 5, PCR positive for Pneumocystis 2, CMV with pneumocystis 2. Of the 52 BAL in immunocompetent children the diagnoses were pneumonia with or without atectasia 32, hemosiderosis 7, TB 4. There were 21 positive cultures (47.7%) from 44 samples, isolating Haemophilus influenzae in 7, Pseudomonas aeruginosa in 4, CMV in 3 and Staphylococcus aureus in 2. The results of BAL changed the treatment plan in 29 patients (35%), including change in antibiotic therapy in 14, ganciclovir in 7, or specific therapies in 6. Conclusions: BAL is a useful tool in the treatment of atypical pneumonias and in the immunocomprimised, giving a more accurate diagnosis and therefore determining a more appropriate therapy

Palabras clave : BAL; children; pneumonia; aetiology.

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