ADJUSTMENT OF BRONCHOALVEOLAR LAVAGE VOLUME TO BODY-WEIGHT IN CHILDREN

To define the amount of epithelial lining fluid (ELF) that is recovere d during bronchoalveolar ravage (BAL) in the pediatric age group, we m easured albumin and urea concentrations in serum and BAL fluid (BALF) of 37 children aged 3-15 years without bronchopulmonary disease. The c hildren were studied while undergoing elective surgery for non-pulmona ry illnesses using a BAL protocol adjusted to body weight. ELF increas ed with age in proportion to increases in lavage volume. When correcte d for the child's weight, approximately 20 mu l ELF/kg body weight wer e recovered throughout the age range. ELF derived by determining album in or urea concentrations in BALF were significantly correlated; howev er, considerable variability was observed in older children when the u rea method was used. This was likely due to the increase in dwell time that is known to affect urea concentrations in BALF. In children ELF/ 100 ml BALF was higher than in adults, suggesting a greater permeabili ty of the alveolar membrane in children. These data show that a BAL pr otocol adjusted to body weight will yield constant fractions of ELF in children aged 3-15 years. These results should facilitate the compari son of BALF constituents in children of different age groups. Pediatr Pulmonol. 1996; 21:184-188. (C) 1996 Wiley-Liss, Inc.