Bronchoalveolar lavage

In cystic fibrosis, infections in the lungs cause major problems. We need to be able to detect the presence of an infection in the lungs so we can treat it appropriately. In older children this is easy to do as they can cough up some sputum (mucous) from their lungs and we can test this to see if there are any bugs growing. Small children can't produce sputum, or if they can they tend to swallow it. To know what bugs are growing in the lung we need to do a bronchoscopy and lavage.

A bronchoscopy is a procedure where a doctor can look at the airways in the lungs by using a thin tube with a camera on the end of it (a bronchscope). A lavage is when using the bronchoscope, fluid is squirted into a small part of the lung and then sucked back out. When the fluid is sucked out if collects the mucous that was in the area of the lung where it was squirted. We can then use this fluid to see if there are any bacteria or viruses growing, and if there is any inflammation in the lungs.

Inflammation is the body's natural response to an infection. The body produces more cells that go to area of infection to try and get rid of it. Sometimes this inflammation causes damage to the lungs. We have collected some important information from finding out what children are infected with and how much inflammation they have in their lungs. We have found that infants have infection and inflammation in the lung, even when they appear to well.

We are continuing to measure infection and inflammation in lung, both for clinical and research purposes. There are still so many things we want to understand about infection and inflammation in cystic fibrosis:

• We want to find out why some children have infections and others do not
• We want to know why some children have higher levels of inflammation
• We want to understand the differences in inflammation with different bugs
• And the list goes on....