Efficacy of bronchoalveolar lavage in treating mycoplasma pneumonia and bacterial pneumonia with atelectasis in children.

Abstract

Background: Pulmonary atelectasis (PA) is a severe complication of pneumonia in children. Despite the growing use of fiberoptic bronchoscopy, the effectiveness of bronchoalveolar lavage (BAL) in treating PA caused by various pathogens remains uncertain. This study aims to evaluate the efficacy of BAL in PA associated with different pathogens and to identify factors influencing treatment outcomes.

Methods: We conducted a retrospective analysis on 185 children with PA between 2017-2021. Clinical data were collected and compared between different groups using a propensity score-matching analysis.

Results: A total of 185 patients were included in the study, divided into two groups based on whether BAL was performed (BAL group, n=146; non-BAL group, n=39). The patients in the BAL group had a longer fever duration, a higher proportion of neutrophils, elevated lactate dehydrogenase (LDH) levels, and a longer duration of antibiotic use prior to admission (all P<0.05). After applying propensity score matching (PSM), 35 cases were enrolled in each group. We further stratified the patients based on the pathogens identified. Furthermore, we found that patients in the Mycoplasma pneumoniae pneumonia (MPP) subgroup had shorter time of C-reactive protein (CRP) recovery and higher incidence of lung recruitment after BAL (all P<0.05), while these results were not observed in the bacterial pneumonia subgroup (P>0.05).

Conclusions: BAL could increase the incidence of lung recruitment and shorten the CRP recovery time in MPP patients with PA, but it could not make any improvement in PA patients caused by the bacterium.