CYTOLOGICAL CHANGES IN ENDOTRACHEAL ASPIRATES ASSOCIATED WITH CHRONICLUNG-DISEASE

Endotracheal aspirates taken serially from mechanically ventilated pre mature infants born at <28 weeks gestation between March 1992 and Augu st 1993 were studied to determine whether early cytological changes wo uld be a good predictor of lung damage in infants who develop chronic lung disease (CLD). CLD was diagnosed if the infant required supplemen tal oxygen at 36 weeks corrected gestational age. Fifty-five infants w ere 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) an d were ventilated for a significantly longer period (43.3+/-26.6 vs. 1 9.3 +/- 12.8 days, p < 0.0001). Endotracheal aspirate cytology showed that infants with CLD had significantly more degenerated columnar epit helial 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 inflamma tory response were found in the tracheal aspirates of a group of infan ts clinically diagnosed with CLD. (C) 1998 Elsevier Science Ireland Lt d.