Pulmonary aspiration and lipid‐laden macrophages: In search of gold (standards)

Colombo, John L.; Hallberg, Timothy K.

doi:10.1002/(sici)1099-0496(199908)28:2<79::aid-ppul1>3.3.co;2-1

Cited by 8 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The staining method and semiquantitiative index used are the same as previously reported by CORWIN and IRWIN [11]. From the available literature, it is difficult to determine the measurement properties of this index because there is uncertainty regarding the gold standard for aspiration [18]. Most studies have used relatively crude indicators such as response to therapy, clinically witnessed aspiration, barium oesophagography or conventional single-channel 24-h pH monitoring to detect aspiration [11±13, 15,21].…”

Section: Discussionmentioning

confidence: 99%

“…Determination of cell counts in induced sputum separated from saliva is a reliable noninvasive method of assessing airway inflammation [16], and the use of an index of macrophages in sputum staining positive for intracellular lipid has been reported [17]. In previous studies there have been two difficulties, the lack of a "gold standard" for the diagnosis of aspiration and the inclusion of patients with a variety of chronic respiratory diseases [18]. Therefore, the present study investigated the diagnostic value of an index of sputum lipid-laden macrophages in identifying acid aspiration, using dual-channel 24-h pH monitoring, in subjects without any chronic respiratory disorder other than asthma.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Lipid-laden macrophages in induced sputum are a marker of oropharyngeal reflux and possible gastric aspiration

Parameswaran¹,

Anvari²,

Efthimiadis³

et al. 2000

Eur Respir J

View full text Add to dashboard Cite

The diagnostic properties of a "lipid index" of macrophages in induced sputum as a noninvasive marker of aspiration of acidic gastric contents were evaluated.In a cross-sectional study, 33 subjects (17 with symptoms suggestive of gastrooesophageal reflux) with normal chest radiographs and no symptoms of aspiration or sinus disease, underwent dual-channel 24-h ambulatory oesophageal pH recording and sputum induction. Oropharyngeal reflux, defined as at least one episode of a fall in pH to <4 at the upper oesophageal electrode, was considered indicative of aspiration of acidic gastric contents ("gold standard"). An index for the presence of intracellular lipid in sputum macrophages, detected by oil red O stain, was obtained. The sensitivity, specificity and predictive values of this "lipid index" were calculated.The "lipid index" could be calculated in 29 of 33 samples with high interobserver repeatability (intraclass correlation coefficient 0.96). Twenty subjects showed oropharyngeal reflux and nine did not. The median "lipid index" in subjects with oropharyngeal reflux (24.5) was significantly greater than that in those without reflux (1.0) (p<0.001). A "lipid index" of 7.0 had a sensitivity of 90%, a specificity of 89%, a positive predictive value of 95% and a negative predictive value of 80%.A "lipid index" of 7.0 in the macrophages of induced sputum is a good marker of oropharyngeal reflux.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Lipid-laden macrophages in induced sputum are a marker of oropharyngeal reflux and possible gastric aspiration

Parameswaran¹,

Anvari²,

Efthimiadis³

et al. 2000

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Apparently, this "normal" reflux is often not associated with cough. The presence of lipid laden macrophages in bronchoalveolar lavage (BAL) fluid may reflect chronic aspiration [86], but is not specific [87,88].…”

Section: Reflux and Aspirationmentioning

confidence: 99%

The diagnosis and management of chronic cough

Morice¹

2004

European Respiratory Journal

468

360

View full text Add to dashboard Cite

“…Some degree of gastro-oesophageal reflux is common in infants and improves with time. The presence of lipid laden macrophages in BAL fluid may reflect chronic aspiration, 31 but it is also a feature of other chronic respiratory disorders and hence probably not very specific for aspiration as the primary cause of cough. 32 …”

mentioning

confidence: 99%