Abstract
The presence of pulmonary infiltrates in PICU patients constitues a diagnostic dilemma. The efficacy of fibrobronchoscopy (FBC) and BAL was evaluated in 24 patients who's age ranged from 2 to 16 years. Nine Patients were inmunodefficient: 6 suffered hematologic disease (1 had AIDS) and 3 had undergone liver or cardiac transplantation. The rest had neurological (8), cardiac (4) or other diseases (3). Fifty three percent had bilateral pulmonary infiltrates. Thirty two FBC with BAL were performed. Twenty patients were on mechanical ventilatory support and 9 were intubated under general anesthesia. No complications due to the procedure were registered. Bacteriology of the BAL was negative in 14 cases (44%); 3 alveolar hemorrage (macrophages and hemosiderin) 4 adult respiratory distress syndrome, 3 cardiogenic pulmonary edema, 2 sequelar lesions,1 neumothorax and 1 was under antibiotic treatment. Positive bacteriological results (>10 Colony Forming Units) in 56% were obtained. Single bacteria in 5:Ps Ag in 3, KES in 1 and Acinethobacter in 1. Combined bacteria in 4, CMVirus in 8 and Pnemocystis Carinii in 2. Our results show the usefulness of BAL in the etbiological diagnosis of the pulmonary infiltrates in pediatric critically ill patients.
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Minces, P., De La Canal, A., Schnitzler, E. et al. BRONCO ALVEOLAR LAVAGE (BAL): USE IN PEDIATRICS. Pediatr Res 33, 659 (1993). https://doi.org/10.1203/00006450-199306000-00029
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DOI: https://doi.org/10.1203/00006450-199306000-00029
