Early application of bronchoalveolar lavage with electronic bronchoscopy in pediatric drowning cases:Single-center experience
10.3760/cma.j.issn.1673-4912.2025.01.010
- VernacularTitle:早期电子支气管镜肺泡灌洗在野外淹溺患儿中的应用：单中心经验
- Author:
Xiong ZHOU
1
;
Jie HE
1
;
Ying LIU
1
;
Kang HUANG
1
;
Yani PENG
1
;
Desheng ZHU
1
;
Zhenghui XIAO
1
;
Xinping ZHANG
1
Author Information
1. 湖南省儿童医院重症医学科，长沙 410007
- Publication Type:Journal Article
- Keywords:
Wild;
Drowning;
Bronchoalveolar lavage with electronic bronchoscopy;
Critically illness;
Pediatric critical illness score;
Children
- From:
Chinese Pediatric Emergency Medicine
2025;32(1):50-55
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of early bronchoalveolar lavage using electronic bronchoscopy in pediatric drowning cases.Methods:A retrospective analysis of clinical data from 81 pediatric drowning cases treated in the intensive care unit of Hunan Children's Hospital from January 2017 to September 2023 was conducted.Among these,43 cases underwent bronchoalveolar lavage with electronic bronchoscopy within 24 hours of drowning,constituting the treatment group,while 38 cases either did not receive treatment within 24 hours or underwent the procedure after 24 hours,forming the control group.We compared the two groups regarding pre-admission observations,admission observations,and disease progression or prognosis indicators to assess the clinical efficacy of early bronchoalveolar lavage with electronic bronchoscopy in pediatric drowning cases.Results:Compared to the control group,children in the treatment group exhibited a significant reduction in invasive ventilation time [(73.33±13.33) h vs.(94.82±15.77) h] and a significant decrease in pediatric intensive care unit stay [105.00 (94.00,121.00) h vs.123.5 (109.75,149.00) h],with both differences being statistically significant( P<0.05).No significant differences in white blood cell count and neutrophil percentage were observed between the treatment group and control group at admission and on the first day( P>0.05).However,by the third day,there was a significant improvement in white blood cell count in both groups,with statistical significance( P<0.05).There was a significant decrease in C-reactive protein and procalcitonin levels between the treatment group and control group on the 1st and 3rd days,with the differences being significant( P<0.05).Six hours after electronic bronchoalveolar lavage,the P/F ratio in the treatment group was lower than that in the control group (177.09±41.27 vs. 233.50±48.23),but it increased more significantly at 24 hours (286.00±34.32 vs.256.34±44.22),with a significant difference between two groups.The positive rate of lavage fluid culture in the treatment group was significantly higher than that in the control group,and the difference was statistically significant( P<0.05).There was no significant difference in the number of organ function damage between two groups( P>0.05).However,regarding prognosis,the treatment group showed significantly better outcomes than the control group( P<0.05). Conclusion:For pediatric patients with wilderness drowning,early electronic bronchoscopy with alveolar lavage may shorten the duration of invasive mechanical ventilation and pediatric intensive care unit stay,improving prognosis,and is worth promoting.
