Risk factors of multiple bronchoscope lavage therapy in children with refractory Mycoplasma pneumoniae pneumonia

Abstract

Objective To investigate the risk factors of single and multiple bronchoscopic lavage therapy in children with refractory Mycoplasma pneumoniae pneumonia(RMPP). Methods Retrospective analysis was conducted of the clinical data of 332 RMPP children at Department of Respiratory Disease, Children′s Hospital of Soochow University from January 2011 to December 2016.The patients were divided into the single group and the multiple group (≥2 times), and the correlative index were compared between the 2 groups.Logistic regression analysis was performed to analyze the risk factors of multiple bronchoscopic lavage therapy in RMPP patients. Results Among 332 children, 223 cases were in the single group and 109 cases in the multiple group.Children undergoing multiple bronchoscopy had the fever duration ≥10 days before the bronchoscopy and course of disease ≥10 days before the bronchoscopy, more than those in the single group [118 cases (52.9%) vs.71 cases (65.1%), 69 cases (29.6%) vs.45 cases(41.3%)], and the differences were statistically significant(all P 44 mg/L, lactate dehydrogenase(LDH) and LDH> 480 U/L were higher than those in the single group, and the differences were significant (all P 44 mg/L(OR=2.638, 95%CI: 1.356-5.133, P=0.004), LDH>480 U/L(OR=2.326, 95%CI: 1.302-4.157, P=0.004)and mucosal erosion(OR=11.15, 95%CI: 2.503-49.715, P=0.002). Conclusion Severe inflammatory reaction and whether or not to actively resist infection and inflammation in the early stage, were important risk factors for multiple bronchoscopic procedures. Key words: Refractory Mycoplasma pneumoniae pneumonia; Child; Bronchoscopy; Number of lavage