Tracheal aspirates

Tracheal aspirate cultures (semiquantitative analysis of pathogenic bacteria)... 

Tracheal aspirates grow more organisms than invasive quantitative cultures and often result in overuse of antibiotics. 

The advantage of this method is that it separates colonization from infection better than culturing tracheal aspirates. 

Tracheal aspiration Suctioning of secretions from the trachea. 

Buss IH, Senthilmohan R, Darlow BA, MogridgeN, Kettle AJ, Winterboum CC (2003) 3-Chlorotyrosine as a Marker of Protein Damage by Myeloperoxidase in Tracheal Aspirates from Preterm Infants Association with Adverse Respiratory Outcome. Pediatr Res 53 455... 

Moison RM, de Baufort AJ, Haasnoot AA, et al, Uric acid and ascorbic acid redox ratio in plasma and tracheal aspirate of... 

C. el al. (1998). Reduction of respiratory syncytial virus (RSV) in tracheal aspirates in intubated infants by use of humanized monoclonal antibody to RSV F protein.y. Infect. Dis. 178, 1555-1561. 

Fig. 2.4. Nasopharyngeal and tracheal aspiration. Barium outlines the nasopharynx (n) and the trachea (t). Only a trace of barium remains in the esophagus...

Interfadal Tensiometry of Tracheal Aspirate from Infants with Neonatal Respiratory Distress Syndrome... 

Abstract The interfacial properties of tracheal aspirate from infants with untreated neonatal respiratory distress syndrome (NRDS), and NRDS infants after therapy with the exogenous surfactant Curosurf were assessed. The interfacial characteristics of the aspirate (equilibrium surface tension, maximal and minimal surface tension during lateral compression-decompression cycles) were determined with the pendant drop method. Our results show that the tracheal aspirate of infants with untreated NRDS had high equilibrium, maximal and minimal surface tension values. In contrast, the samples from infants, treated with Curosurf , showed lower surface tension values, suggesting that the application of Curosurf improves the composition and the properties of the pulmonary surfactant in the infant lung. 

The aim of the work presented is to evaluate the physiological status of tracheal aspirate from infants with NRDS before and after Curosurf therapy via interfacial tensiometry. The measurements are made by the pendant drop method, which requires a minimal volume of the clinical samples. 

Tracheal aspirate (TA) was obtained by low volume lavage (1 ml) from intubated newborns with NRDS. Exogenous surfactant was administered in accordance with international protocols for Curosurf in the sixth postnatal hour. TA was obtained prior to and 12 hours after surfactant administration. For control the pure Curosurf dispersion was also tested. 

The dynamic characteristics of the samples studied also showed a significant improvement after the exogenous surfactant preparation application Ymax reduced from 52 mN/m before the therapy to 32 mN/m after treatment with Curosurf . The maximal surface tension of the pure preparation was 25 mN/m, i.e. tracheal aspirate values approached the parameters of the exogenous surfactant. The results are shown in Fig. 2. 

The findings presented in this note represent a physicochemical proof in vitro of the efficiency of the Curosurf treatment in vivo. On the other hand, they demonstrate the applicability of the pendant drop ADSA, which requires a minimal amount of tracheal aspirate, as a fast, informative and useful technique for in-time alveolar surfactant diagnostics. 

Rudiger, M, von Baehr, A, Haupt, R, Wauer, RR and Rilstow, B (2000) Preterm infants with high polyunsaturated fatty acid and plasmalogen content in tracheal aspirates develop bronchopulmonary dysplasia less often. Crit Care Med, 28, 1572-1577. 

Expectorated sputum and tracheal aspirate specimens obtained by direct suctioning through the endotracheal tube in mechanically ventilated patients are easily obtained but notoriously nonspecific in the diagnosis of nosocomial pneumonia. Bartlett et al. prospectively evaluated cultures of expectorated sputum in 67 patients with nosocomial pneumonia whose final diagnosis was based on bacterial studies from uncontamined specimens (blood, transtracheal... 

Even when the clinical diagnosis of pneumonia is accurate, results of Gram s stain examination and culture of tracheal aspirates could be misleading when choosing the appropriate antibiotics. In the study by Fagon et al., only... 

The antibody-coated bacteria test is another microscopic procedure that has been applied to tracheal aspirates from intubated patients. The results from one study were similar to those reported for sputa from patients not receiving ventilation, with low sensitivity in detection of pneumonia (48%-73%) but excellent specificity (98%-100%) (46). In another study, however, specificity was only 56% when compared to quantitative PSB cultures (47). It has also been suggested that a positive antibody-coated test (1) may precede a subsequent infection, (2) may be positive when quantitative culture results are low because of prior antimicrobial treatment or poor specimen handling or processing, and (3) may show antibiotic effectiveness by conversion to a negative test after treatment. 

Wunderink RG, Russell GB, Mezger E, et al. The diagnostic utility of the anti-body-coated bacteria test in intubated patients. Chest 1991 99 84-88. Lambert RS, Vereen EE, George RB. Comparison of tracheal aspirates and protected brush catheter specimens for identifying pathogenic bacteria in mechanically ventilated patients. Am J Med Sci 1989 297 377-382. 

A tracheal aspirate positive for bacteria at the time of surgery is associated with an increased risk of postoperative pneumonia (12,13). In a prospective study of 100 patients undergoing cardiac surgery, a culture was obtained by endotracheal tube immediately after induction of anesthesia and tracheal intubation (12). Lower respiratory tract infection later developed in 8 of 26... 

Zickmann B, Sabblotdd A, Fussle R, Gorlach G, Hempehnann G. Perioperative microbio logic monitoring of tracheal aspirates as a predictor of pulmonary complications after cardiac operations. J Thorac Cardiovasc Surg 1996 111 1213-1218. 

Biochemical studies have demonstrated the presence of surface-active components, predominantly phospholipids, in airway secretions (42). Bernhard et al. (43,44) studied the conductive airway phospholipids in the tracheobronchial secretions of adult pigs and compared their results with analyses of bronchoalveolar lavage (B AL) fluid, tracheobronchial epithelium, and lung parenchyma. The composition of the PC and PL molecular species of the tracheal aspirates was similar... 

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