Surfactant deficiency in infants with severe acute viral bronchiolitis.

Abstract

OBJECTIVES:

To evaluate surfactant content and function through the lamellar body count (LBC) and stable microbubble test (SMT) in mechanically ventilated infants with severe acute viral bronchiolitis.

STUDY DESIGN:

Controlled cross-sectional study of 32 infants receiving mechanical ventilation: 16 with a diagnosis of acute viral bronchiolitis and 16 with normal lungs. Tracheal fluid was collected and LBC was performed in an automated cell counter. Samples were kept frozen and thawed for testing. At the time of analysis, samples were diluted in a dithiothreitol solution, vortexed for 10 seconds, and aspirated by the cell counter. SMT was performed using the Pattle technique.

RESULTS:

In the bronchiolitis group, the median (IQR) LBC was significantly lower than in the control group: 130,000 (61,250-362,250) vs. 518,000 (180,250-896,000) lamellar bodies/μL; P = .003. Median (IQR) SMT values were also significantly lower in the bronchiolitis group: 10 (2-13) vs. 400 (261-615) microbubbles/mm2; P < .001.

CONCLUSIONS:

Infants with acute viral bronchiolitis have reduced surfactant content and function. We speculate that these simple tests may be useful to identify infants with bronchiolitis who would benefit from surfactant replacement therapy.

• Authors: Francine Hartmann, Humberto Holmer Fiori, Pedro Celiny Ramos Garcia, Jefferson Piva, Renato Machado Fiori
• Journal: The Journal of pediatrics (J Pediatr) Vol. 164 Issue 6 Pg. 1432-5 (Jun 2014) ISSN: 1097-6833 [Electronic] United States
• PMID: 24657121 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Pulmonary Surfactants
• Surface-Active Agents

Topics

• Acute Disease
• Bronchiolitis, Viral (diagnosis, therapy)
• Bronchoalveolar Lavage Fluid (chemistry)
• Case-Control Studies
• Combined Modality Therapy
• Critical Care (methods)
• Cross-Sectional Studies
• Deficiency Diseases (diagnosis, therapy)
• Female
• Follow-Up Studies
• Humans
• Infant, Newborn
• Intensive Care Units, Neonatal
• Male
• Microbubbles
• Pulmonary Surfactants (analysis)
• Reference Values
• Respiration, Artificial (methods)
• Risk Assessment
• Severity of Illness Index
• Statistics, Nonparametric
• Surface-Active Agents (therapeutic use)
• Survival Rate
• Time Factors
• Treatment Outcome