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Cytopathologic examinations of tracheobronchial aspirates from 108 infants sampled
during mechanical ventilation demonstrated a well-defined progression of cytologic
changes in bronchial cells that could be divided into three classes. Seventy percent
of infants with respiratory distress syndrome who developed bronchopulmonary dysplasia
had pulmonary effluent cytology designated Class III; no infants with RDS but without
BPD had these cytologic findings. Additionally, a temporal progression of events involving
polymorphonuclear leukocyte and macrophage populations occurred in the absence of
infection; these events were associated with duration of assisted ventilation and
oxygen exposure. The technique described provides a useful way to monitor the progression
of lung injury and repair and offers a cytologic method to predict and diagnose the
development of bronchopulmonary dysplasia.