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(Chest. 1995;107:185-188.)
© 1995 American College of Chest Physicians

Aspiration Complicating Bronchopulmonary Dysplasia

Peggy J. Radford MD, FCCP1; Paul C. Stillwell MD, FCCP2; Barbara Blue MSN, RN3; and Grant Hertel MD1

1 From the Phoenix Children's Hospital, Phoenix
2 From the Cleveland Clinic Foundation, Cleveland
3 From the Lutheran General Hospital, Des Plaines, Illinois

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 children who had flexible bronchoscopy between 1987 and 1990; 11 of 12 had bronchoalveolar lavage (BAL). The lipid index (LI) was used to quantify the degree of lipid-laden macrophages in the BAL fluid as a marker of aspiration. The age range at the time of bronchoscopy was 3 months to 5 years. The LI was considered positive in 6 of 11 subjects. A pH probe study was done on seven subjects with concordant findings in five. Other findings included dynamic or structural airway abnormalities in 10 of the 12 subjects. These data suggest that aspiration frequently is associated with BPD in addition to the previously recognized dynamic and structural airway problems. The predisposition to gastroesophageal reflux and laryngeal injury probably accounts for the increased aspiration risk in children with BPD.

Key Words: aspiration • bronchopulmonary dysplasia • bronchoscopy • gastroesophageal reflux

Submitted on July 22, 1993
Accepted on May 18, 1994




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