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儿童支气管肺泡灌洗术后发热的发病率及相关因素

Incidence rate and factors related to post-bronchoalveolar lavage fever in children.

作者信息

Fonseca M T Mohallem, Camargos P A M, Abou Taam R, Le Bourgeois M, Scheinmann P, de Blic J

机构信息

Departamento de Pediatria da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

Respiration. 2007;74(6):653-8. doi: 10.1159/000107737. Epub 2007 Aug 29.

Abstract

BACKGROUND

Post-bronchoscopy and bronchoalveolar lavage (BAL) fever in children has been described by several authors.

OBJECTIVES

This study aimed at assessing the occurrence of fever after these examinations and associated risk factors.

METHODS

The study was performed in the Bronchoscopy Unit of Hôpital Necker-Enfants Malades, Paris, France, from June 2004 to July 2005. 148 children who underwent fiberoptic bronchoscopy and BAL, and remained in the Unit for 24 h, were included.

RESULTS

37.8% of the patients presented post-BAL fever. In the multivariate analysis of the selected factors (age, immunodeficiency, general or local anesthesia, mucosal biopsy, inflammation and suppuration at the moment of the examination, abnormal bronchoalveolar fluid cellularity and infection), only age <2 years and presence of infection remained associated with fever.

CONCLUSIONS

The occurrence of fever is a frequent event in children who underwent BAL. In order to reduce post-BAL fever, antibiotic strategies should be devised based on prospective studies assessing identification of predictive air-way infection criteria and/or rapid bacteriological result analysis.

摘要

背景

已有多位作者描述过儿童支气管镜检查及支气管肺泡灌洗(BAL)后发热的情况。

目的

本研究旨在评估这些检查后发热的发生率及相关危险因素。

方法

该研究于2004年6月至2005年7月在法国巴黎内克尔儿童医院支气管镜科进行。纳入了148例行纤维支气管镜检查及BAL且在科室留观24小时的儿童。

结果

37.8%的患者出现了BAL后发热。在对所选因素(年龄、免疫缺陷、全身或局部麻醉、黏膜活检、检查时的炎症和化脓、支气管肺泡液细胞计数异常及感染)进行多因素分析时,仅年龄<2岁及存在感染与发热相关。

结论

发热在接受BAL的儿童中是常见事件。为降低BAL后发热,应基于评估预测气道感染标准识别及/或快速细菌学结果分析的前瞻性研究制定抗生素策略。

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