Radionuclide study of bronchial aspiration in intensive care newborn children

Newborn children, fitted with tracheal prosthesis for mechanical ventilation, may present chronic pulmonary complications due to the repetition of silent aspirations following gastroesophageal reflux. We evaluated, in a newborn intensive care population, the frequency of such aspirations and the relationship between the different parameters and pathologies. This particular group of sick neonates cannot be moved, and as the hospital for the newborn is far from the Nuclear Medicine district, the patients cannot be scanned. We used a simple technique: the injection of a solution of 99Tcm-sulphur colloid in their gastric tube, and the measurement of the tracheal aspiration tubes' radioactivity. Thirty one children were tested; thirteen children (42%) had radioactive tracheal tubes. The study of the relationship between several parameters and our results, shows that the examination was generally positive when the maximal insufflation pressure value was low. Our results prove that silent aspirations are very frequent in such a population and that it will be perhaps useful to prevent them in a systematic way in order to save the neonates from developing pulmonary lesions.