ASPIRATION COMPLICATING BRONCHOPULMONARY DYSPLASIA

The purpose of this study was to study the relationship of aspiration with ongoing respiratory difficulties in infants with bronchopulmonary dysplasia (BPD). Twelve infants with BPD were identified out of 314 c hildren who had flexible bronchoscopy between 1987 and 1990; 11 of 12 had bronchoalveolar lavage (BAL). The lipid index (LI) was used to qua ntify the degree of lipid-laden macrophages in the BAL fluid as a mark er of aspiration. The age range at the time of bronchoscopy was 3 mont hs to 5 years. The LI was considered positive in 6 of 11 subjects. A p H probe study was done on seven subjects with concordant findings in f ive. Other findings included dynamic or structural airway abnormalitie s in 10 of the 12 subjects. These data suggest that aspiration frequen tly is associated with BPD in addition to the previously recognized dy namic and structural airway problems. The predisposition to gastroesop hageal reflux and laryngeal injury probably accounts for the increased aspiration risk in children with BPD.