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Immunocytochemical detection of milk proteins in tracheal aspirates of ventilated infants: A pilot study
Author(s) -
Miller Jamey,
Colasurdo Giuseppe N.,
Khan Amir M.,
Jajoo Charu,
Patel Tarak J.,
Fan Leland L.,
Elidemir Okan
Publication year - 2002
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.10189
Subject(s) - medicine , staining , immunostaining , enteral administration , pulmonary aspiration , mechanical ventilation , pathology , neonatal intensive care unit , immunohistochemistry , anesthesia , pediatrics , parenteral nutrition
In this study, we evaluated immunocytochemical staining for milk proteins (α‐lactalbumin and β‐lactoglobulin) in tracheal aspirates of mechanically ventilated infants, and assessed whether this staining technique supported a clinical diagnosis of aspiration in infants receiving orogastric feedings. All newborns requiring mechanical ventilation in the neonatal intensive care unit of a major tertiary care hospital were potential subjects for this study. Tracheal aspirates were obtained prior to the introduction of enteral feeding and at various time points thereafter in newborns requiring mechanical ventilation. Cells were obtained and processed for immunocytochemical staining of α‐lactalbumin and β‐lactoglobulin. In total, 88 specimens recovered from 34 infants were adequate for staining. Alveolar macrophages recovered from most of the infants who were never fed (true negative controls) did not display immunoreactivity for milk proteins: 4/34 or 12% of infants' aspirates demonstrated presence of milk proteins before enteral feeding was commenced. Tracheal aspirates obtained from 12 infants after introduction of enteral feedings appeared to support clinical and radiological findings suggestive of aspiration events, with positive immunostaining on several occasions. These observations support our work in a murine model and demonstrate that immunocytochemical staining of tracheal aspirates for milk proteins may enhance the ability to diagnose pulmonary aspiration. Further studies are needed to define the clinical significance of our findings and the effects of single and repeated aspiration events on respiratory status. Pediatr Pulmonol. 2002; 34:369–374. © 2002 Wiley‐Liss, Inc.