{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T17:20:13Z","timestamp":1772126413465,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study is an addition to the already published prospective randomized double-blinded trial by Tschiedel et al. that compared two different sedation regimes in fiberoptic flexible bronchoscopy in pediatric subjects. The objective of the presented study is to analyze the correlation between the neutrophil percentage of the bronchoalveolar lavage fluid (BALF) and coughing episodes during bronchoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty subjects, aged 1\u201317\u2005years, received flexible fiberoptic bronchoscopy under deep sedation. The BALF of 39 subjects was analyzed with reference to cytology and microbiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The percentage of neutrophils from the total cell count ranged from 0% to 95.3% (median 2.7). Nineteen patients (49%) had a percentage of \u22653.0%. Pearson's correlation showed a high correlation (<jats:italic>r\u2009<\/jats:italic>=\u20090.529, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) between the coughing episodes per minute and the neutrophil percentage in the BALF. Analysis of variance showed a significant difference in neutrophil percentage between the indication groups (<jats:italic>p\u2009<\/jats:italic>=\u20090.013). The <jats:italic>t<\/jats:italic>-test (<jats:italic>p<\/jats:italic>\u2009=\u20090.019) showed a significant difference between the neutrophil percentage for patients with a probable airway infection under immunosuppression (median 2.9) and patients with cystic fibrosis (median 49.6). The linear regression analysis showed a significantly stronger impact of the neutrophil percentage on coughing frequency than the sedation regime (<jats:italic>\u03b2<jats:sub>neutrophils<\/jats:sub><\/jats:italic>\u2009=\u20090.526 with <jats:italic>p<\/jats:italic>\u2009=\u20090.001 vs. <jats:italic>\u03b2<jats:sub>sedation<\/jats:sub><\/jats:italic>\u2009=\u20090.165 with <jats:italic>p<\/jats:italic>\u2009=\u20090.251).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When bronchoscopy is to be performed on a pediatric patient with suspected bacterial or viral infection, and therefore neutrophilic airway inflammation, coughing is to be expected.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1347983","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T04:40:21Z","timestamp":1720413621000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Neutrophilia in the bronchoalveolar lavage fluid increases coughing during flexible fiberoptic bronchoscopy in a pediatric cohort"],"prefix":"10.3389","volume":"12","author":[{"given":"Laura","family":"Danino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Stehling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Eckerland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eser","family":"Orhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Tschiedel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1136\/adc.66.4.481","article-title":"Fibreoptic bronchoscopy without general anaesthetic","volume":"66","author":"Raine","year":"1991","journal-title":"Arch Dis Child"},{"key":"B2","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.prrv.2010.10.006","article-title":"The role of rigid and flexible bronchoscopy in children","volume":"12","author":"Nicolai","year":"2011","journal-title":"Paediatr Respir Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1183\/09031936.02.02072001","article-title":"Complications of flexible bronchoscopy in children: prospective study of 1,328 procedures","volume":"20","author":"de Blic","year":"2002","journal-title":"Eur Respir J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1159\/000334110","article-title":"Flexible bronchoscopy","volume":"73","author":"Yonker","year":"2012","journal-title":"Adv Otorhinolaryngol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1002\/ppul.25235","article-title":"Sedation for bronchoscopy in children: a prospective randomized double-blinded trial","volume":"56","author":"Tschiedel","year":"2021","journal-title":"Pediatr Pulmonol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1034\/j.1399-3003.2000.16f15.x","article-title":"Chronic cough in children: bronchoalveolar lavage findings","volume":"16","author":"Fitch","year":"2000","journal-title":"Eur Respir J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1002\/ppul.22792","article-title":"Wet cough in children: infective and inflammatory characteristics in broncho-alveolar lavage fluid","volume":"49","author":"Wurzel","year":"2014","journal-title":"Pediatr Pulmonol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1002\/ppul.23351","article-title":"Protracted bacterial bronchitis: the last decade and the road ahead","volume":"51","author":"Chang","year":"2016","journal-title":"Pediatr Pulmonol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1164\/rccm.201503-0474ST","article-title":"Official American thoracic society technical standards: flexible airway endoscopy in children","volume":"191","author":"Faro","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1097\/00000542-200204000-00031","article-title":"Practice guidelines for sedation and analgesia by non-anesthesiologists","volume":"96","year":"2002","journal-title":"Anesthesiology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1183\/09031936.00.15121700","article-title":"Bronchoalveolar lavage in children. 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