title: Surfactant deficiency in infants with severe acute viral bronchiolitis.
abstract: OBJECTIVE
  To evaluate surfactant content and function through the lamellar body count (LBC) and stable microbubble test (SMT) in mechanically ventilated infants with severe acute viral bronchiolitis.
  
  
  METHODS
  Controlled cross-sectional study of 32 infants receiving mechanical ventilation: 16 with a diagnosis of acute viral bronchiolitis and 16 with normal lungs. Tracheal fluid was collected and LBC was performed in an automated cell counter. Samples were kept frozen and thawed for testing. At the time of analysis, samples were diluted in a dithiothreitol solution, vortexed for 10 seconds, and aspirated by the cell counter. SMT was performed using the Pattle technique.
  
  
  RESULTS
  In the bronchiolitis group, the median (IQR) LBC was significantly lower than in the control group: 130,000 (61,250-362,250) vs. 518,000 (180,250-896,000) lamellar bodies/μL; P = .003. Median (IQR) SMT values were also significantly lower in the bronchiolitis group: 10 (2-13) vs. 400 (261-615) microbubbles/mm2; P < .001.
  
  
  CONCLUSIONS
  Infants with acute viral bronchiolitis have reduced surfactant content and function. We speculate that these simple tests may be useful to identify infants with bronchiolitis who would benefit from surfactant replacement therapy.
authors.affiliation: Department of Pediatrics, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: Francine
authors.initials: F
authors.lastname: Hartmann
authors.affiliation: Department of Pediatrics, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: Humberto Holmer
authors.initials: HH
authors.lastname: Fiori
authors.affiliation: Department of Pediatrics, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: Pedro Celiny
authors.initials: PC
authors.lastname: Ramos Garcia
authors.affiliation: Department of Pediatrics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Jefferson
authors.initials: J
authors.lastname: Piva
authors.affiliation: Department of Pediatrics, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: Renato Machado
authors.initials: RM
authors.lastname: Fiori
mesh_terms: D000208:Acute Disease; D001990:Bronchiolitis, Viral / Q000175:diagnosis* / Q000628:therapy*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D045423:Microbubbles; D011663:Pulmonary Surfactants / Q000032:analysis*; D012016:Reference Values; D012121:Respiration, Artificial / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013501:Surface-Active Agents / Q000627:therapeutic use*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011663:Pulmonary Surfactants; D013501:Surface-Active Agents