Safety of bronchoalveolar lavage in young children with cystic fibrosis

Wainwright, C. E., Grimwood, K., Carlin, J. B., Vidmar, S., Cooper, P.J., Francis, P. W. J., Byrnes, C.A., Whitehead, B.F., Martin, A. J., Robertson, I. F, Cooper, D. M., Dakin, C. J., Masters, I. B., Massie, R.J., Robinson, P. J., Ranganathan, S., Armstrong, D.S., Patterson, L. K. and Robertson, C. F. (2008) Safety of bronchoalveolar lavage in young children with cystic fibrosis. Pediatric Pulmonology, 43 10: 965-972. doi:10.1002/ppul.20885


Author Wainwright, C. E.
Grimwood, K.
Carlin, J. B.
Vidmar, S.
Cooper, P.J.
Francis, P. W. J.
Byrnes, C.A.
Whitehead, B.F.
Martin, A. J.
Robertson, I. F
Cooper, D. M.
Dakin, C. J.
Masters, I. B.
Massie, R.J.
Robinson, P. J.
Ranganathan, S.
Armstrong, D.S.
Patterson, L. K.
Robertson, C. F.
Title Safety of bronchoalveolar lavage in young children with cystic fibrosis
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 8755-6863
Publication date 2008-10-01
Year available 2008
Sub-type Article (original research)
DOI 10.1002/ppul.20885
Open Access Status Not yet assessed
Volume 43
Issue 10
Start page 965
End page 972
Total pages 8
Place of publication United States
Publisher John Wiley & Sons
Language eng
Subject 920115 Respiratory System and Diseases (incl. Asthma)
920501 Child Health
110203 Respiratory Diseases
111403 Paediatrics
Abstract Objective: Our aim was to determine the safety of BAL in young children<6 years with CF. Methods: As part of a multi-center study of BAL-directed therapy, children with CF<6 years had one or more BALs between September 1999 and December 2005. Adverse events were recorded intraoperatively and for 24 hr thereafter. Clinical characteristics before BAL, findings at bronchoscopy and BAL results were assessed as risk factors for adverse events. Results: 333 BALs were conducted in 107 (56 males) children, median age 23.5 (range 1.6–67.5) months, including 170 (51%) for pulmonary exacerbation. 29 BALs (8.7%) were followed by fever 38.58C and 10 (3%) had clinically significant episodes (five intraoperative hemoglobin desaturations to <90% requiring intervention, one tachyarrhythmia, two needing post-operative supplemental oxygen, one hospitalization for stridor). Two contaminated bronchoscopes were detected. 180 minor adverse events were recorded in 174 (52%) BAL procedures (137 altered cough, 41 fever <38.58C). Low percentage BAL return (P¼0.002) and focal bronchitis (P¼0.02) were associated with clinically significant deterioration. Multivariable analysis identified Streptococcus pneumoniae (OR 22.3; 95% confidence interval (CI); 6.9,72), Pseudomonas aeruginosa (OR 2.4; 95% CI 1.0, 5.8), respiratory signs (OR 5.0; 95% CI 1.7, 14.6) and focal bronchitis (OR 5.9; 95% CI1.2, 29.8) as independent risk factors for post-bronchoscopy fever38.58C. Conclusions: Adverse events are common with BAL in young CF children, but are usually transient and well tolerated. Parents should be counseled that signs of a pre-existing lower respiratory infection are associated with increased risk of post-BAL fever
Keyword Cystic Fibrosis
Bronchoalveolar Lavage
Fever
Adverse Events
Safety
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 9937868
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Tue, 07 Apr 2009, 01:50:00 EST by Amanda Jones on behalf of Royal Brisbane Clinical School