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Quantification of the source, amount and duration of aspiration in the lungs of infants using gamma scintigraphy
Beth L Laube1, Richard Katz1, Gerald M Loughlin2
1Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Background:
Aspiration can cause acute symptoms and chronic lung disease in the developing lung. However, the source of aspiration in infants is often unclear, making the choice of intervention difficult.
Objective:
To quantify the source, amount and duration of lung aspiration in infants using gamma scintigraphy.
Methods:
Two infants with clinical evidence of gastroesophageal reflux and oropharyngeal dysphagia swallowed formula radiolabeled with 99mtechnetium on Visit 1. Radiolabeled-formula was instilled by nasogastric tube on Visit 2. Lung aspiration was quantified over four hours and expressed as percent of total radioactivity administered.
Results:
Aspiration was greatest with swallowing, compared to instillation, peaking between 2.0% and 2.4% within 30 min and between 0.40% and 0.65% within 20 min, respectively. Radioactivity remained above zero four hours after either administration.
Conclusions:
Quantification of the source, amount and duration of lung aspiration in infants is feasible using gamma scintigraphy. The impact of aspiration accrual on clinical care deserves further investigation.
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