| 11 th Annual Pediatric Critical Care Colloquium |
| Session/Time | Pulmonary I/Thu, 9:45 - 12 00 PM |
| Title | New Method of Broneboalveolar Lavage in Pediatric Patients |
| Author | JS Roberts, TV Brogan, LD Martin |
| Affiliation | Department of Anesthesiology and Critical Care, Children's Hospital and Regional Medical Center, Seattle, Washington |
| Introduction | Bronchoalveolar lavage allows fluid collection with a high sensitivity for a wide variety of disease processes in mechanically ventilated patients. However, in pediatric patients this procedure can be complicated by the small size of the endotracheal tube, particularly if significant mechanical ventilatory support is required. We describe the use of a small caliber catheter placed through the endotracheal tube allowing sitnulataneous fluid lavace and aspiration, in an animal model and a patient cohort |
| Method | Animal Data- New Zealand white rabbits were anesthetized, intubated and mechanically ventilated. A 5F40cm lavage catheter (Cook lnc. Bloomington, IN) was placed until resistance was met, then normal saline was favaaed throuch the distal port and simultaneously aspirated through the proximal port. In one animal, continuous fluoroscopy was used to visualize the placement of the catheter and contrastmaterial was instilled and aspirated. Patient Data: A case series of pediatric patients in the intensive care unit at CHRMC who had bronchoalveolar lava-e usin- the new catheter method is reported. Data include a-e, weicht, dia-nosis, ventilatory status, coagulation status, amount of lava-efluid placed and recovered, results of lavage fluid studies, patient outcomes and chances in therapy directed by the lava-e. |
| Result | Animal Data: Six rabbits underwent 2 bronchoalveolar lavaae procedures each, usin- the0 C2 lavacye.catheter. Fluid collection was successm in all 12 trials with recovery of 45 + 25% and ' 36 + 26% of luid instilled in trial I and 2, respectively.Fluoroscopy demostrated the catheter in the ri-ht lobe,with subsegmental fillinc, by the instilled contrast.Patient Data: Six patients underwent 7 bronchoalveolar lava-es procedures usina the lavage catheter. The mean a-e was 1 1.5 + 6.5 months and the mean weiaht was 8.0 + 2.5 kg. Fluid collection was successful in 5/6 patients and 6/7 lavages. The volume of lavage fluid recovered was 37 + 17 % of the instilled volume. Therapy chances were made in 3 of 6 patients based on lavacyc results. There were no complications due to the catheter lavage. |
| Conclusion | Bronclioalveolar lavage usina a double lumen catheter can provide highly sensitive sample collection and crucial diagnostic information in mechanically ventilated patients. The new method of catheter lavage allonvs safe sample collection in patients with small andotricheal tubes. |
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