title: Increased volume of tracheal aspirate fluid predicts the development of bronchopulmonary dysplasia.
abstract: BACKGROUND
  Elevated cytokine concentrations were observed in tracheal aspirate fluid (TAF) of infants on mechanical ventilation who subsequently developed bronchopulmonary dysplasia (BPD). However, there are few reports that systematically evaluate the amount of TAF as an indicator of BPD development.
  
  
  OBJECTIVE
  To clarify whether TAF volume during the first week of life predicts BPD development in extremely low gestational age newborns (ELGANs).
  
  
  METHODS
  We analyzed 51 infants, born at gestational age of <28 weeks and ventilated for more than 7 days after birth, among whom, 26 were diagnosed with BPD based on the clinical definition of oxygen dependence at 36 weeks postmenstrual age (BPD group) and 25 were included in the non-BPD group. Sum of TAF scores (STS) was calculated by semi-quantification of TAF volume at each suctioning and the suctioning frequency during the first week of life.
  
  
  RESULTS
  STS was significantly higher in the BPD group than in the non-BPD group (median (interquartile range): 77 (29-126) vs. 28 (22-59), p<0.001). STS (cut-off, 60) with area under the curve in receiver operating analysis of 0.75 was significantly predictive of BPD development. Multivariate logistic regression analysis adjusted for perinatal characteristics showed that STS≥60 was a significant risk factor for BPD development (odds ratio, 7.50; confidence interval, 1.16-48.40, p=0.034).
  
  
  CONCLUSIONS
  Increased TAF volume during the first week of life was an independent predictor for BPD development in ventilated ELGANs, indicating that increased pulmonary capillary permeability may influence the pathogenesis of BPD.
authors.affiliation: Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, 1-1-1 Takakuradai, Suma-Ku, Kobe, Hyogo, Japan. iwatani_kch@hp.pref.hyogo.jp
authors.forename: Sota
authors.initials: S
authors.lastname: Iwatani
authors.forename: Masami
authors.initials: M
authors.lastname: Mizobuchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kei
authors.initials: K
authors.lastname: Inomata
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sakai
authors.forename: Seiji
authors.initials: S
authors.lastname: Yoshimoto
authors.forename: Hideto
authors.initials: H
authors.lastname: Nakao
mesh_terms: D001826:Body Fluids; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D012121:Respiration, Artificial; D012307:Risk Factors; D014132:Trachea / Q000473:pathology*