Analysis of Celis and Surfactant Composition in Bronchoalveolar Lavage Fluid in Children Without Pulmonary Disease

Purpose To investigate cell type and surfactant components in bronchoalveolar lavage fluid (BALF) in anaesthetized children without pulmonary diseases. Methods The study group consisted of 20 children at median age of 3.7 yr (4 mo to 10.3 yr) undergoing surgery for nonpulmonary illness. A flexible bronchoscope ( working channel of 1. 2 mm and outer diameter of 2. 5 mm) was wedged into the middle lobe or one of its segments. BALF was obtained from repeated wash with 3×0.7 mL/kg body weight of normal saline warmed to body temperature. The first sample was discarded; and subsequent samples were pooled for analysis. The sediment after centrifugation was used for cytological analysis while the supernatant for mea-surement of total phospholipid (TPL), disaturated phosphatidylcholine (DSPC), total protein (TP) and surfactant protein A (SP-A). Results Median values for BALF recovery was 46. 6% and that for total cell counts (TCC) were 156 × 103/mL. The relative proportion of macrophages and lymphocytes was 93.9% and 4.5% , respectively. TPL was 46.6 μg/mL, DSPC 17. 9 μg/mL, TP 72.2 μg/mL, DSPC to TPL (DSPC/TPL) 42.2% , DSPC to TP ratio (DSPC/TP) 0.28 , and SP-A 1. 91 μg/mL. There was no significant correlation between TCC, TPL, TP, SP-A and age. Heart rate, respiration, oxygen saturation and blood pressure were not influenced. Conclusions The results of this study provided the basis for cy-tology and surfactant components of BALF in children, and may be referenced for understanding of physiolo-gy and pathophysiology of lung injury in children.