Wall-mounted versus handheld syringe suction for pediatric
bronchoalveolar lavage: A Randomized controlled trial
Abstract
Background: Bronchoalveolar lavage (BAL) via flexible bronchoscopy is a
valuable diagnostic technique in children. The quality of BAL is
directly related to the volume of the fluid recovered. Continuous wall
suctioning and the handheld syringe suctioning are the two commonly used
methods, but they are rarely compared in children. We aimed to compare
the above two suctioning techniques for BAL in the pediatric age group.
Methods: This randomized controlled study enrolled children of age one
month to 18 years of age undergoing flexible bronchoscopy and BAL. We
compared continuous wall suctioning and the handheld syringe suctioning
technique. The primary outcome was the percentage of BAL fluid recovery
in two different suctioning techniques. Secondary outcomes included
technical acceptable BAL and yield of various diagnostic tests in BAL.
Results: The study included 73 children (48 boys) with a median (IQR)
age of 30 (8, 108) months. There were 37 children in wall mount group
and 36 children in syringe suction group. The baseline characteristics
of the groups were similar. The wall mount suction had more recovery of
BAL fluid compared to the syringe method (43.6±8.4% vs 37.8±8.5%,
p-value 0.004). The proportion of BAL having fluid recovery of ≥40% was
also high in wall mount suction [31 (83.8%) vs 17 (47.2%); p-value
0.001]. There was no difference in diagnostic yield between the
groups. Conclusion: Wall mount suction had better BAL fluid recovery
compared to handheld syringe suction in children undergoing flexible
bronchoscopy. The diagnostic yield was similar in both groups.