Newborn tracheal aspirate cytology: Classification during respiratory distress syndrome and bronchopulmonary dysplasia

https://doi.org/10.1016/S0022-3476(81)80603-8Get rights and content

Cytopathologic examinations of tracheobronchial aspirates from 108 infants sampled during mechanical ventilation demonstrated a well-defined progression of cytologic changes in bronchial epithelial cells that could be divided into three classes. Seventy percent of infants with respiratory distress syndrome who developed bronchopulmonary dysplasia had pulmonary effluent cytology designated Class III; no infants with RDS but without BPD had these cytologic findings. Additionally, a temporal progression of events involving polymorphonuclear leukocyte and macrophage populations occurred in the absence of infection; these events were associated with duration of assisted ventilation and oxygen exposure. The technique described provides a useful way to monitor the progression of lung injury and repair and offers a cytologic method to predict and diagnose the development of bronchopulmonary dysplasia.

References (34)

  • TaghizadehA et al.

    Pathogenesis of bronchopulmonary dysplasia following hyaline membrane disease

    Am J Pathol

    (1976)
  • D'AblangG et al.

    Neonatal pulmonary cytology and bronchopulmonary dysplasia

    Acta Cytol

    (1975)
  • JacobJ et al.

    The contribution of PDA in the neonate with severe RDS

    J Pediatr

    (1980)
  • OppermannHC et al.

    Bronchopulmonary dysplasia in premature infants—a radiological and pathological correlation

    Pediatr Radiol

    (1977)
  • AveryME et al.
  • EdwardsDK et al.

    The immature lung: radiographic appearance, course, and complications

    AJR

    (1980)
  • ZmoraE et al.

    Use of side-hold endotracheal tube adapter for tracheal aspiration

    Am J Dis Child

    (1980)
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