A bronchoscopic scoring system for airway secretions-airway cellularity and microbiological validation

There is currently no validated scoring system for quantification of airway secretions in children. A user friendly, valid scoring system of airway secretions during flexible bronchoscopy (FB) would be useful for comparative purposes in clinical medicine and research. The objective of this study was...

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Bibliographic Details
Published in:Pediatric pulmonology 2006-09, Vol.41 (9), p.887-892
Main Authors: Chang, A.B., Faoagali, J., Cox, N.C., Marchant, J.M., Dean, B., Petsky, H.L., Masters, I.B.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Bronchoscopy
Child, Preschool
cough
Female
Humans
Male
Medical sciences
mucus
Mucus - cytology
Mucus - microbiology
Pneumology
Respiratory System - secretion
Respiratory system : syndromes and miscellaneous diseases
scoring
validation
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Summary:There is currently no validated scoring system for quantification of airway secretions in children. A user friendly, valid scoring system of airway secretions during flexible bronchoscopy (FB) would be useful for comparative purposes in clinical medicine and research. The objective of this study was to validate our bronchoscopic secretion (BS) scoring system by examining the relationship between the amount of secretions seen at bronchoscopy with airway cellularity and microbiology. In 106 children undergoing FB, the relationship of BS grades with bronchocalveolar lavage (BAL) cellularity and infective state (bacterial and viral infections) were examined using receptor operator curves (ROC). BAL was obtained according to European Respiratory Society guidelines; first lavage for microbiology and second lavage for cellularity. Area under the ROC was significant for total cell count (TCC) and neutrophil % but not for lymphocyte %. BS grade significantly related to infection positive state (χ trend2 = 5.85, P = 0.016). The area under the ROC for infection positive state versus BS grade was 0.645, 95% CI 0.527–0.763. The BS scoring system is a valid method for quantifying airway secretions in children undergoing bronchoscopy. The system related well to airway cellularity and neutrophilia, as well as to an airway infective state. However, the system is only complementary to cell counts and cultures and cannot replace these laboratory quantification techniques. Pediatr Pulmonol. © 2006 Wiley‐Liss, Inc.
ISSN:8755-6863
1099-0496
DOI:10.1002/ppul.20478