TY - JOUR T1 - Benefits and risks of bronchoalveolar lavage in severe asthma in children JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00332-2021 SP - 00332-2021 AU - Raja Ben Tkhayat AU - Jessica Taytard AU - Harriet Corvol AU - Laura Berdah AU - Blandine Prévost AU - Jocelyne Just AU - Nadia Nathan Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/09/29/23120541.00332-2021.abstract N2 - Background Although bronchoscopy can be part of the exploration of severe asthma in children, the benefit of bronchoalveolar lavage (BAL) is unknown. The present study aims at deciphering if systematic BAL during a flexible bronchoscopy procedure could better specify the characteristics of severe asthma and improve asthma management.Material and Methods The study took place in two departments of a university hospital in Paris. Children who underwent flexible bronchoscopy for the exploration of severe asthma between April 2017 and September 2019 were retrospectively included.Results In total, 203 children were included, among whom 107 had a BAL. BAL cell count was normal in most cases, with an increasing number of eosinophils with age, independently from the atopic status of the patients. Compared with bronchial aspiration only, BAL increased the rate of identified bacterial infection by 1.5. Nonatopic patients had more bacterial infections (p<0.001). BAL induced a therapeutic modification only for azithromycin and omalizumab prescriptions. The practice of a BAL decreased bronchoscopy tolerance (p=0.037), especially in the presence of tracheobronchial malacia (p<0.01) and when performed in a symptomatic patient (p=0.019).Discussion and conclusion Although BAL may provide interesting information in characterising severe asthma, in most cases its impact on the patient's management remains limited. Moreover, BAL can be poorly tolerated and should be avoided in the case of tracheobronchial malacia or current asthma symptoms.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Ben Tkhayat has nothing to disclose.Conflict of interest: Dr. Taytard has nothing to disclose.Conflict of interest: Dr. Corvol has nothing to disclose.Conflict of interest: Dr. Berdah has nothing to disclose.Conflict of interest: Dr. Prevost has nothing to disclose.Conflict of interest: Dr. Just has nothing to disclose.Conflict of interest: Dr. Nathan has nothing to disclose. ER -