Bronchoalveolar lavage in children

Bronchoalveolar lavage (BAL) is routinely performed in adults for sampling cellular and biochemical components. Many studies have been performed that have enabled the proposal of recommendations for BAL, methodology and processing, as well as reference values in different clinical settings. In contrast, despite a world-wide increase in the use of BAL in children, including neonates, there are, at the present time, no clear recommendations on the methodology, the clinical applications and the research areas for BAL. ATask Force on BAL in children has been approved by the European Respiratory Society (ERS) Task Force committee 1996. The objectives of this task force were: 1) to provide recommendations and guidelines on how to perform BAL and how to process the return fluid in children; 2) to collect and discuss available reference values; 3) to list indications and results in both immunocompetent and immunocompromised children; 4) to define areas for future research. This task force included paediatric respiratory physicians involved in bronchoscopy and BAL and was run as a collaboration between the Paediatric Bronchology Group and the BAL scientific group of the ERS. On the basis of the available literature, this report provides recommendations about processing, "normal" values and indications for BAL.Members also discussed the main fields for further studies in order to standardize and improve the clinical value of BAL in children.