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Wall-mounted versus handheld syringe suction for pediatric bronchoalveolar lavage: A Randomized controlled trial
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  • Aruna Herath,
  • Kana Jat,
  • Rakesh Lodha,
  • Venkateswaran Iyer,
  • Jayati Sarangi,
  • Sushil Kabra
Aruna Herath
All India Institute of Medical Sciences
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Kana Jat
All India Institute of Medical Sciences
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Rakesh Lodha
All India Institute Of Medical Sciences, New Delhi
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Venkateswaran Iyer
All India Institute Of Medical Sciences, New Delhi
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Jayati Sarangi
All India Institute of Medical Sciences
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Sushil Kabra
All India Institute of Medical Sciences
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Abstract

Background: Bronchoalveolar lavage (BAL) via flexible bronchoscopy is a valuable diagnostic technique in children. The quality of BAL is directly related to the volume of the fluid recovered. Continuous wall suctioning and the handheld syringe suctioning are the two commonly used methods, but they are rarely compared in children. We aimed to compare the above two suctioning techniques for BAL in the pediatric age group. Methods: This randomized controlled study enrolled children of age one month to 18 years of age undergoing flexible bronchoscopy and BAL. We compared continuous wall suctioning and the handheld syringe suctioning technique. The primary outcome was the percentage of BAL fluid recovery in two different suctioning techniques. Secondary outcomes included technical acceptable BAL and yield of various diagnostic tests in BAL. Results: The study included 73 children (48 boys) with a median (IQR) age of 30 (8, 108) months. There were 37 children in wall mount group and 36 children in syringe suction group. The baseline characteristics of the groups were similar. The wall mount suction had more recovery of BAL fluid compared to the syringe method (43.6±8.4% vs 37.8±8.5%, p-value 0.004). The proportion of BAL having fluid recovery of ≥40% was also high in wall mount suction [31 (83.8%) vs 17 (47.2%); p-value 0.001]. There was no difference in diagnostic yield between the groups. Conclusion: Wall mount suction had better BAL fluid recovery compared to handheld syringe suction in children undergoing flexible bronchoscopy. The diagnostic yield was similar in both groups.

Peer review status:UNDER REVIEW

29 May 2020Submitted to Pediatric Pulmonology
01 Jun 2020Assigned to Editor
01 Jun 2020Submission Checks Completed
02 Jun 2020Reviewer(s) Assigned
05 Jul 2020Review(s) Completed, Editorial Evaluation Pending