• Yuanyuan Zhang, Ying Chen, Zhimin Chen, Yunlian Zhou, Yuanjian Sheng, Dan Xu, and Yingshuo Wang.
• Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
• Respir Care. 2014 Sep 1;59(9):1433-9.

IntroductionThis study prospectively evaluated the effect of early bronchoalveolar lavage (BAL) on refractory Mycoplasma pneumoniae pneumonia with radiologically proven large pulmonary lesions in children.MethodsA total of 35 children diagnosed as having refractory M. pneumoniae pneumonia with radiologically proven large pulmonary lesions completed the study. According to the time point of BAL, they were divided into 2 groups. In the early BAL group, BAL was performed within 3 d after admission (n = 22); in the late BAL group, BAL was performed 3 d later after admission (n = 13). Clinical effects were compared between these 2 groups.ResultsAfter BAL therapy, improvement in clinical symptoms and laboratory findings as well as resolution of pulmonary lesions on radiography were obtained in all subjects. The median fever duration after admission was 4 (2-7) d and 5 (2-10) d (P < .05), and the median hospitalization duration was 7 (5-10) d and 10 (5-14) d (P < .05), respectively, in the early BAL group and the late BAL group. Approximately 7 d after admission, 67% of subjects in the early BAL group showed resolution of atelectasis on x-ray image versus a corresponding rate of 14% in the late BAL group (P < .05). Furthermore, laboratory indices recovered quicker in the early BAL group than in the late BAL group (P < .01).ConclusionsBAL appeared to be efficacious and well-tolerated treatment for refractory M. pneumoniae pneumonia with radiologically proven large pulmonary lesions, and early application of BAL may be more beneficial.Copyright © 2014 by Daedalus Enterprises.

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