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Airway inflammation in children with tracheostomy
1Children's Hospital, University of Munich, Munich, Germany. matthias-griese@med.uni-muenchen.de
Pediatric Pulmonology
|March 17, 2004
Summary
Children with tracheostomy may have lower surfactant protein D levels, increasing risk for airway inflammation. This study found reduced SP-D in children with tracheostomies, linked to bacterial presence and neutrophils.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Respiratory Medicine
Background:
- Long-term tracheostomy in children may lead to chronic airway inflammation and remodeling.
- Pulmonary surfactant proteins (SP) A and D are crucial for lung defense against microorganisms.
- The impact of tracheostomy on surfactant proteins and airway inflammation in children is not fully understood.
Purpose of the Study:
- To investigate peripheral airway inflammation and surfactant protein deficiencies in non-symptomatic children with tracheostomies.
- To compare airway inflammation markers and surfactant protein levels in children with and without tracheostomies.
Main Methods:
- Assessed bronchoalveolar lavage (BAL) cell patterns, bacteria, and viruses in 46 children with tracheostomies and 16 controls.
- Measured concentrations of surfactant proteins SP-A, SP-B, SP-C, and SP-D.
- Analyzed correlations between surfactant proteins, inflammatory markers, and bacterial presence.
Main Results:
- Children with tracheostomies showed increased total cells and neutrophils in BAL fluid, with more frequent bacterial recovery.
- No viruses were detected in either group.
- A significant 50% reduction in SP-D concentration was observed in children with tracheostomies (P = 0.0002).
- SP-A, SP-B, and SP-C levels did not differ between groups.
- Lower SP-D concentrations correlated inversely with neutrophil counts and were associated with higher bacterial loads.
Conclusions:
- Non-symptomatic children with tracheostomies exhibit signs of airway inflammation, characterized by increased neutrophils.
- Reduced surfactant protein D (SP-D) levels in these children may impair host defense.
- Bacterial presence and low SP-D concentrations likely contribute to neutrophilic inflammation in the lower respiratory tract of children with tracheostomies.
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