Cytological changes in endotracheal aspirates associated with chronic lung disease.
Endotracheal aspirates taken serially from mechanically ventilated premature infants born at < 28 weeks gestation between March 1992 and August 1993 were studied to determine whether early cytological changes would be a good predictor of lung damage in infants who develop chronic lung disease (CLD). CLD was diagnosed if the infant required supplemental oxygen at 36 weeks corrected gestational age. Fifty-five infants were enrolled in the study, five died and of the 50 infants remaining, 17 (34%) developed CLD. The infants with CLD had a significantly lower gestation (25.5 +/- 1.8 (mean +/- 1 SD) versus 26.2 +/- 0.9 weeks, p < 0.05), significantly more required surfactant (14/17 vs. 16/33, p < 0.05) and were ventilated for a significantly longer period (43.3 +/- 26.6 vs. 19.3 +/- 12.8 days, p < 0.0001). Endotracheal aspirate cytology showed that infants with CLD had significantly more degenerated columnar epithelial cells on day 3 (p = 0.001), and more neutrophils on day 10 (p = 0.007). Though not predictive of CLD, cytological changes consistent with bronchial epithelial and pulmonary damage followed by an inflammatory response were found in the tracheal aspirates of a group of infants clinically diagnosed with CLD.
Todd
D A
DA
Department of Neonatology, Westmead Hospital, NSW, Australia. Davidt@westmed.wh.usyd.edu.au
Earl
M
M
Lloyd
J
J
Greenberg
M
M
John
E
E
D002908:Chronic Disease; D003581:Cytodiagnosis; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008171:Lung Diseases / Q000209:etiology / Q000473:pathology*; D008297:Male; D010100:Oxygen / Q000627:therapeutic use; D012121:Respiration, Artificial; D013396:Suction; D014132:Trachea / Q000473:pathology*
D010100:Oxygen