The repeatability of nonbronchoscopic bronchoalveolar lavage differential cell counts

Warke, T.J.; Kamath, Sridhar; Fitch, P.S.; Brown, Vanessa; Shields, Michael; Ennis, Madeleine

doi:10.1183/09031936.01.00203101

Cited by 21 publications

(18 citation statements)

References 17 publications

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“…The protected catheter has the advantage of avoiding contamination of the sample with upper airway flora or secretion. (51) Some studies have confirmed the reproducibility of culture results (51) and of differential cell counts (52) in different samples obtained with this technique.…”

Section: Mechanical Ventilation and Non-bronchoscopic Balmentioning

confidence: 69%

Celularidade do líquido de LBA em crianças e adolescentes saudáveis e com doenças pulmonares

2010

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The objective of this study was to review the literature on bronchoalveolar lavage fluid cell profiles in healthy children and adolescents, as well as on the use of BAL as a diagnostic and follow-up tool for lung disease patients in this age bracket. To that end, we used the Medline database, compiling studies published between 1989 and 2009 employing the following MeSH descriptors (with Boolean operators) as search terms: bronchoalveolar lavage AND cytology OR cell AND child. In healthy children, the cell profile includes alveolar macrophages (> 80%), lymphocytes (approximately 10%), neutrophils (approximately 2%) and eosinophils (< 1%). The profile varies depending on the disease under study. The number of neutrophils is greater in wheezing children, especially in non-atopic children, as well as in those with pulmonary infectious and inflammatory profiles, including cystic fibrosis and interstitial lung disease. Eosinophil counts are elevated in children/adolescents with asthma and can reach high levels in those with allergic bronchopulmonary aspergillosis or eosinophilic syndromes. In a heterogenous group of diseases, the number of lymphocytes can increase. Evaluation of the BAL fluid cell profile, when used in conjunction with clinical and imaging findings, has proven to be an essential tool in the investigation of various lung diseases. Less invasive than transbronchial and open lung biopsies, BAL has great clinical value. Further studies adopting standard international protocols should be carried out. Such studies should involve various age groups and settings in order to obtain reference values for BAL fluid cell profiles, which are necessary for a more accurate interpretation of findings in children and adolescents with lung diseases.Keywords: Bronchoalveolar lavage; Bronchoalveolar lavage fluid/cytology; Child; Adolescent. ResumoEste estudo teve como objetivo rever a literatura existente sobre a celularidade do LBA em crianças e adolescentes saudáveis, bem como sobre sua utilização como método propedêutico e de acompanhamento nas afecções pulmonares neste grupo etário. Para tanto, utilizamos o banco de dados médico Medline com a seleção de artigos publicados entre 1989 e 2009 utilizando os seguintes descritores MeSH com operadores boolianos: bronchoalveolar lavage AND cytology OR cell AND child. Em crianças saudáveis, a celularidade é composta por macrófagos alveolares (> 80%), linfócitos (cerca de 10%), neutrófilos (cerca de 2%) e eosinófilos (< 1%). O perfil celular sofre alterações de acordo com a doença estudada. Ocorre uma elevação no número de neutrófilos em sibilantes, especialmente os não atópicos, bem como em indivíduos com quadros infecciosos e inflamatórios pulmonares, incluindo fibrose cística e doenças intersticiais pulmonares. Os eosinófilos se elevam em crianças/adolescentes com asma e podem atingir níveis acentuados na aspergilose broncopulmonar alérgica e nas síndromes hipereosinofílicas. A elevação dos linfócitos pode ocorrer em um grupo heterogêneo de doenças. Conclui-se que a...

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Section: Mechanical Ventilation and Non-bronchoscopic Balmentioning

confidence: 69%

Celularidade do líquido de LBA em crianças e adolescentes saudáveis e com doenças pulmonares

2010

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“…Excellent repeatability, as indicated by a Lin's concordance coefficient, Rc, Ͼ0.9 [5] was observed for the major breath metabolites acetone, isoprene and ammonia (Table 1). For all metabolites examined observed mean coefficients of variability (Cv), were Ͻ20%.…”

Section: Experiments Imentioning

confidence: 80%

“…Analysis of repeatability was performed on logtransformed data through computation of Lin's concordance correlation coefficient [5] and the mean intraindividual coefficient of variability, determined as the average ratio of the standard deviation and the mean of paired datasets. Use of log-transformed data is in accordance with previous studies which show the concentrations of common breath metabolites follow more closely a log-normal distribution [6].…”

Section: Breath Sampling Methodologymentioning

confidence: 99%

Repeatability of the measurement of exhaled volatile metabolites using selected ion flow tube mass spectrometry

Boshier

Marczin

Hanna

2010

J. Am. Soc. Mass Spectrom.

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Selected ion flow tube mass spectrometry, SIFT-MS, has been used to determine the repeatability of the analysis of volatile metabolites within the breath of healthy volunteers, with emphasis on the influence of sampling methodology. Baseline instrument specific coefficients of variability for examined metabolites were as follows: acetone (1%), ammonia (1%), isoprene (2%), propanol (6%), ethanol (7%), acetic acid (7%), and hydrogen cyanide (19%). Metabolite concentration and related product ion count rate were identified as strong determinants of measurement variation. With the exception of ammonia, an orally released metabolite, variability in repeated on-line breath analysis tended to be lower for metabolites of systemic origin. Standardization of sampling technique improved the repeatability of the analysis of selected metabolites. Off-line (bag) alveolar breath sampling, as opposed to mixed (whole) breath sampling, likewise improved the repeatability of the analysis of all metabolites investigated, with the exception of acetic acid. We conclude that SIFT-MS analysis of common volatile metabolites within the breath of healthy volunteers is both reliable and repeatable. For selected metabolites, the finding that repeatability is improved through modification of sampling methodology may have implications in terms of future recommended practices.

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“…BAL and BAL examination BAL was obtained using a standardised and repeatable [26] nonbronchoscopic technique. Briefly, with the child's head turned to the left, a catheter was passed as far as possible through the endotracheal tube, ensuring that it went beyond the estimated carina site.…”

Section: Methodsmentioning

confidence: 99%

Calcitonin gene-related peptide relates to cough sensitivity in children with chronic cough

Chang¹,

Gibson²,

Ardill³

et al. 2007

European Respiratory Journal

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Airway neuropeptides, in particular calcitonin gene-related peptide (CGRP), are likely to be important in the pathogenesis of chronic cough. The present authors evaluated the following: 1) the relationship between cough sensitivity and bronchoalveolar lavage (BAL) neuropeptides; and 2) the effect of reflux oesophagitis (RO) on cough, cough sensitivity and BAL neuropeptides in children not selected for cough. It was hypothesised that CGRP would be increased in children with chronic cough and would relate to cough sensitivity.Capsaicin cough sensitivity was performed in children undergoing gastro-duodenal endoscopy. CGRP, substance P and neurokinin A were measured in BAL obtained nonbronchoscopically. Children were defined as ''coughers'' if chronic cough was present.Coughers (n521) had significantly reduced cough sensitivity but were just as likely as noncoughers (n519) to have RO. The median CGRP was significantly higher in coughers with oesophagitis than in noncoughers with oesophagitis. CGRP significantly negatively correlated to cough sensitivity in coughers but not in noncoughers.Elevated calcitonin gene-related peptide, but not substance P or neurokinin A, is only associated with chronic cough in children when oesophagitis coexists. Calcitonin gene-related peptide in bronchoalveolar lavage relates to cough sensitivity and is likely to be important in the pathophysiology of chronic cough.

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The repeatability of nonbronchoscopic bronchoalveolar lavage differential cell counts

Cited by 21 publications

References 17 publications

Celularidade do líquido de LBA em crianças e adolescentes saudáveis e com doenças pulmonares

Celularidade do líquido de LBA em crianças e adolescentes saudáveis e com doenças pulmonares

Repeatability of the measurement of exhaled volatile metabolites using selected ion flow tube mass spectrometry

Calcitonin gene-related peptide relates to cough sensitivity in children with chronic cough

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