Falcon 50 ml

The decision of whether to perform bronchoscopy with BAL was made by the attending pediatricians. A flexible bronchoscope (Olympus CV260, Tokyo, Japan) was used to assess primary abnormalities of the airways and clear all secretions or mucus plugs. In brief, the BAL was performed in the right middle lobe when diffuse infiltrates were evident on radiography; otherwise, it was performed at the site of localized infiltration. The recovered BAL fluid was pooled; 60%-80% of the instilled volume was recovered. BAL was collected by a sterile sputum-collecting pipe (Falcon 50 ml, Becton-Dickinson, Rutherford, NJ, USA) for microbiological analysis.

Before the electronic bronchoscopy procedure, parents were notified of the potential surgical risks and provided informed consent. Pediatric patients were required to fast from both solids and liquids for at least 6–8 h prior to the procedure. Premedication in the form of intramuscular atropine sulfate, at a dose of 0.01–0.02 mg/kg, was given to the children. The procedure was performed under the care of experienced anesthesiologists. An electronic bronchoscopy (Olympus CV260, Tokyo, Japan) was wedged into each lobe. Foreign body forceps or brush were used to clean and remove the plastic sputum suppository in order to restore unobstructed airway passage Normal saline (0.9%) was used for local irrigation before and after cleaning up the plastic phlegm suppository. Local irrigations were 1ml/kg each time, and first 3 lavages were collected by a sterile sputum-collecting pipe (Falcon 50 ml, Becton-Dickinson, Rutherford, NJ, USA). The collected BAL sample was used for cell counts, viral analysis, and microbiological analysis (bacteria and MP).

Parents/guardians were informed about the surgical risks of FB and signed consent was obtained prior to the procedure. Children were fasted for both solids and liquids for at least 6 h prior to the procedure. Intramuscular atropine sulfate 0.01–0.02 mg/kg and midazolam 0.2–0.4 mg/kg were administered as premedication. Upper and lower airway anesthesia was achieved with 2 % lidocaine. A flexible bronchoscope (Olympus CV260, Tokyo, Japan or Fujinon EB-270P, Miyoshi, Japan) was wedged into each lobe. The airways were washed three times with 1 ml/kg of prewarmed sterile 0.9 % saline solution, which was then collected by a sterile sputum-collecting pipe (Falcon 50 ml, Becton-Dickinson, Rutherford, NJ, USA). The collected BAL was used for cell counts, viral analysis, and microbiological analysis (bacteria and Mycoplasma pneumoniae).