Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1993 Jul;69(1 Spec No):44–48. doi: 10.1136/adc.69.1_spec_no.44

Pulmonary inflammatory cells in ventilated preterm infants: effect of surfactant treatment.

S Arnon 1, J Grigg 1, M Silverman 1
PMCID: PMC1029397  PMID: 8346953

Abstract

The aim of this study was to determine the effect of surfactant treatment on the number and distribution of inflammatory cells in bronchoalveolar lavage fluid (BALF) from mechanically ventilated preterm infants over the first week of life in relation to the subsequent development of chronic lung disease (CLD). The study included 25 babies who received surfactant on clinical grounds and 29 babies of similar severity who did not. BALF was collected on days 1, 3, 5, and 7 after birth. Cell counts were performed and differentials were calculated on 300 cells. CLD was equally common in both treatment groups. Of the 54 infants, 29 (53%) who developed CLD had a higher incidence of patent ductus arteriosus and air leak and needed a higher concentration of inspired oxygen on the fifth and seventh days of life. Babies who developed CLD had more polymorphonuclear leucocytes and fewer macrophages on days 5 and 7 than those who recovered. Surfactant treatment was associated with a higher total white cell count on day 3. Between days 3 and 7, macrophage numbers were higher in surfactant treated babies, whatever the pulmonary outcome. This data suggests that CLD was associated with persistence of high numbers of polymorphonuclear leucocytes in BALF at the end of the first week. Surfactant treatment caused a persistent increase in macrophage numbers. The association between persistent neutrophilia and CLD was unaffected by surfactant treatment.

Full text

PDF
44

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bellanti J. A., Nerurkar L. S., Zeligs B. J. Host defenses in the fetus and neonate: studies of the alveolar macrophage during maturation. Pediatrics. 1979 Nov;64(5 Pt 2 Suppl):726–739. [PubMed] [Google Scholar]
  2. Davis J. M., Dickerson B., Metlay L., Penney D. P. Differential effects of oxygen and barotrauma on lung injury in the neonatal piglet. Pediatr Pulmonol. 1991;10(3):157–163. doi: 10.1002/ppul.1950100305. [DOI] [PubMed] [Google Scholar]
  3. Garcia J. G., Wolven R. G., Garcia P. L., Keogh B. A. Assessment of interlobar variation of bronchoalveolar lavage cellular differentials in interstitial lung diseases. Am Rev Respir Dis. 1986 Mar;133(3):444–449. doi: 10.1164/arrd.1986.133.3.444. [DOI] [PubMed] [Google Scholar]
  4. Grigg J. M., Barber A., Silverman M. Increased levels of bronchoalveolar lavage fluid interleukin-6 in preterm ventilated infants after prolonged rupture of membranes. Am Rev Respir Dis. 1992 Apr;145(4 Pt 1):782–786. doi: 10.1164/ajrccm/145.4_Pt_1.782. [DOI] [PubMed] [Google Scholar]
  5. Grigg J. M., Savill J. S., Sarraf C., Haslett C., Silverman M. Neutrophil apoptosis and clearance from neonatal lungs. Lancet. 1991 Sep 21;338(8769):720–722. doi: 10.1016/0140-6736(91)91443-x. [DOI] [PubMed] [Google Scholar]
  6. Grigg J., Arnon S., Silverman M. Fractional processing of sequential bronchoalveolar lavage fluid from intubated babies. Eur Respir J. 1992 Jun;5(6):727–732. [PubMed] [Google Scholar]
  7. Grigg J., Barber A., Silverman M. Bronchoalveolar lavage fluid glutathione in intubated premature infants. Arch Dis Child. 1993 Jul;69(1 Spec No):49–51. doi: 10.1136/adc.69.1_spec_no.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Jacobs R. F., Wilson C. B., Palmer S., Springmeyer S. C., Henderson W. R., Glover D. M., Kessler D. L., Jr, Murphy J. H., Hughes J. P., van Belle G. Factors related to the appearance of alveolar macrophages in the developing lung. Am Rev Respir Dis. 1985 Apr;131(4):548–553. doi: 10.1164/arrd.1985.131.4.548. [DOI] [PubMed] [Google Scholar]
  9. Merritt T. A., Cochrane C. G., Holcomb K., Bohl B., Hallman M., Strayer D., Edwards D. K., 3rd, Gluck L. Elastase and alpha 1-proteinase inhibitor activity in tracheal aspirates during respiratory distress syndrome. Role of inflammation in the pathogenesis of bronchopulmonary dysplasia. J Clin Invest. 1983 Aug;72(2):656–666. doi: 10.1172/JCI111015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Miller L. C., Isa S., LoPreste G., Schaller J. G., Dinarello C. A. Neonatal interleukin-1 beta, interleukin-6, and tumor necrosis factor: cord blood levels and cellular production. J Pediatr. 1990 Dec;117(6):961–965. doi: 10.1016/s0022-3476(05)80145-3. [DOI] [PubMed] [Google Scholar]
  11. Ogden B. E., Murphy S. A., Saunders G. C., Pathak D., Johnson J. D. Neonatal lung neutrophils and elastase/proteinase inhibitor imbalance. Am Rev Respir Dis. 1984 Nov;130(5):817–821. doi: 10.1164/arrd.1984.130.5.817. [DOI] [PubMed] [Google Scholar]
  12. Peterson M. W., Nugent K. M., Jolles H., Monick M., Hunninghake G. W. Uniformity of bronchoalveolar lavage in patients with pulmonary sarcoidosis. Am Rev Respir Dis. 1988 Jan;137(1):79–84. doi: 10.1164/ajrccm/137.1.79. [DOI] [PubMed] [Google Scholar]
  13. Placzek M., Silverman M. Selective placement of bronchial suction catheters in intubated neonates. Arch Dis Child. 1983 Oct;58(10):829–831. doi: 10.1136/adc.58.10.829. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Schmekel B., Blom-Bülow B., Hörnblad Y., Laitinen L. A., Linden M., Venge P. Granulocytes and their secretory products, myeloperoxidase and eosinophil cationic protein, in bronchoalveolar lavage fluids from two lung lobes in normal subjects. Eur Respir J. 1991 Jul;4(7):867–871. [PubMed] [Google Scholar]
  15. Shennan A. T., Dunn M. S., Ohlsson A., Lennox K., Hoskins E. M. Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period. Pediatrics. 1988 Oct;82(4):527–532. [PubMed] [Google Scholar]
  16. Sherman M. P., D'Ambola J. B., Aeberhard E. E., Barrett C. T. Surfactant therapy of newborn rabbits impairs lung macrophage bactericidal activity. J Appl Physiol (1985) 1988 Jul;65(1):137–145. doi: 10.1152/jappl.1988.65.1.137. [DOI] [PubMed] [Google Scholar]
  17. Sibille Y., Reynolds H. Y. Macrophages and polymorphonuclear neutrophils in lung defense and injury. Am Rev Respir Dis. 1990 Feb;141(2):471–501. doi: 10.1164/ajrccm/141.2.471. [DOI] [PubMed] [Google Scholar]
  18. Sieger L. Pulmonary alveolar macrophages in pre- and post-natal rabbits. J Reticuloendothel Soc. 1978 May;23(5):389–395. [PubMed] [Google Scholar]
  19. Stenmark K. R., Eyzaguirre M., Westcott J. Y., Henson P. M., Murphy R. C. Potential role of eicosanoids and PAF in the pathophysiology of bronchopulmonary dysplasia. Am Rev Respir Dis. 1987 Sep;136(3):770–772. doi: 10.1164/ajrccm/136.3.770. [DOI] [PubMed] [Google Scholar]
  20. Wyllie A. H., Kerr J. F., Currie A. R. Cell death: the significance of apoptosis. Int Rev Cytol. 1980;68:251–306. doi: 10.1016/s0074-7696(08)62312-8. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES