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. 2003 Oct;88(10):922–926. doi: 10.1136/adc.88.10.922

Bronchoalveolar lavage cellularity in infants with severe respiratory syncytial virus bronchiolitis

P McNamara 1, P Ritson 1, A Selby 1, C Hart 1, R Smyth 1
PMCID: PMC1719332  PMID: 14500316

Abstract

Aim: To examine over time, the cellular response within the lungs of infants ventilated with respiratory syncytial virus (RSV) bronchiolitis and to compare this response in infants born at term with those born preterm.

Methods: Non-bronchoscopic bronchoalveolar lavage (BAL) samples were taken from 47 infants (24 born at term and 23 born preterm) who were ventilated for RSV positive bronchiolitis and 10 control infants. BAL cellularity and differential cell counts were calculated using standard techniques.

Results: Total cellularity in BAL over the first four days of ventilation in infants with RSV bronchiolitis was greater in term infants (median 2.2 (IQR 4.27) x 106 cells/ml) compared with preterm infants (0.58 (1.28) x 106 cells/ml). The magnitude of the cellular response in preterm infants with bronchiolitis was similar to that in the control group measured on day 1 (0.62 (0.77) x 106 cells/ml). BAL cellularity decreased progressively from the time of intubation in term infants, but remained relatively constant in preterm infants up to seven days after intubation.

Conclusions: There are differences in the magnitude and type of pulmonary cellular response in term and preterm infants ventilated with RSV bronchiolitis. The cellular response in term infants with bronchiolitis differs from that in a control group of infants. These differences may reflect variations in cellular recruitment in the lung and/or variations in airway calibre.

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Figure 1 .

Figure 1

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Total and individual leucocyte concentrations in term and preterm infants with bronchiolitis and the control group over days 1–4. Eosinophils were only seen in six samples, where they constituted less than 1% of the total. Necrotic and unidentifiable cells were not counted. All respiratory epithelial cells seen were non-viable.

Figure 2 .

Figure 2

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Total cell concentration over the first four days after intubation in term and preterm infants with RSV bronchiolitis. Data are also shown for control group infants (day 1) and six preterm infants still ventilated on day 7.

Figure 3 .

Figure 3

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Neutrophil concentration over the first four days after intubation in term and preterm infants with RSV bronchiolitis. Data are also shown for control group infants (day 1) and six preterm infants still ventilated on day 7.

Selected References

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