Flexible bronchoscopy and BAL:
Informed consent for the procedure was obtained from parents/guardians
of patients before each bronchoscopy, which were all clinically
indicated as part of the patients’ evaluations for persistent wheezing.
The bronchoscopies were done under inhalational anesthesia. The BAL was
obtained from the right middle lobe unless otherwise prompted by more
inflammation in other anatomical locations. We used a maximum of three
aliquots of 10 ml each. The three aliquots were pooled and sent as one
sample for analysis and culture (bacterial, viral). The 2.8mm (Olympus
XP 160) pediatric flexible fiberoptic bronchoscope was used in all
procedures. The scope was introduced through a laryngeal airway to
reduce contamination of the bronchoscope with naso-oropharyngeal flora.