Abstract
The main goal of this study was to assess the cytological evaluation of tracheal aspirate, in order to predict the early diagnosis of bronchopulmonary dysplasia (BPD) in high-risk babies during mechanical ventilation. Method: Samples from 43 infants (aged < 34 weeks and weighed ≤ 1500 g) were examined cytologically; who were admitted to Pediatric Intensive Care Units and diagnosed as respiratory distress syndrome by clinical and radiological criteria. Results: Up to 150 tracheal aspirates from 43 infants were examined to demonstrate cytological changes in bronchial epithelial cells that progressed to dysplasia. It was cytologically designated Class III. According to cytological criteria, all intubated infants had reactive hyperplastic and metaplastic epithelial changes. There were dysplastic changes in 23 out of 33 who developed BPD and 7 out of 40 who had a normal outcome. The variation between the numbers of neonates that had dysplasia in the BPD and the non-BPD group was significant (P < 0.002 by chi-square test). Conclusion: In order to monitor the development of lung injury and repair, tracheal aspirate cytology is simple, non-invasive and fast. Cytological monitoring of respiratory distress infants may be helpful in the early diagnosis and prognosis of the developing BPD. Evaluating new BPD preventive treatment schemes may also be valuable.
Highlights
Bronchopulmonary Dysplasia (BPD) is a severe chronic lung disease that affects newborns precipitately due to lung vascular and alveolar development failure [1, 2]
The purpose of this study is to consider ways to determine the relationship of cytological examination of tracheal aspirate in high-risk neonates, who suspect to develop BPD, whether the procedure of tracheal lavage and aspiration in newborn children with endotracheal tubes was routinely performed for the pulmonary toilet
Compared to the 7 (17.5% of all neonates) patients who did not develop BPD and were discharged at different times, the 23 (57.5%) patient who developed BPD was diagnosed with tracheal aspirate earlier. (Table 3)
Summary
Bronchopulmonary Dysplasia (BPD) is a severe chronic lung disease that affects newborns precipitately due to lung vascular and alveolar development failure [1, 2]. These infants may be hospitalized, accustomed to extra oxygen or a ventilator while having long-lasting airway obstruction symptoms [3, 4]. Clinical or pharmacological treatments are needed to prevent or reverse BPD. These challenges remain a critically important study area for BPD [9, 10]. BPD has far-reaching adverse financial and health effects, including increased use of pediatric care, increased hospitalizations, and poorer early childhood neurodevelopmental and cognitive outcomes [11, 12]
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