Introduction: Lipid laden macrophages (LLM) are reported to be pathognomonic findings in exo- and endo-genous lipoid pneumonia [Allen, Clin Pediatr 1986; 25:541-545]. Several studies found LLM in lungs on autopsy of newborns receiving Intralipid® [Dahms, J.Pediatr 97:800, 1980]. Recalde et al.[Pediatr Pathol. 1984; 2:25-34] showed that LLM are present in tracheal aspirates of newborn infants on IV lipid infusions. Little is known about the usefulness of LLM as a marker of aspiration in neonates.Figure
Purpose: To compare LLM indexes from tracheal aspirates of neonates with and without IV lipids.
Methods: All intubated infants who were not receiving gastric feedings were eligible for the study. Tracheal aspirates were obtained once daily and analyzed for LLM Index. [Corwin, Am Rev Respir Dis.1985;132:576-581]. Alveolar macrophages are graded 0-4 in direct relationship to the amount of lipid per cell. 100 consecutive macrophages are graded; maximal LLM Index = 400
Results: Of 91 samples from 20 babies, 16 were unsatisfactory due to insufficient quantity of material or technical problems. The mean value of LLM index from samples during Intralipid® infusion = 91.8 (SD=59.53), and from samples when no Intralipid® was infused = 24.81 (SD=39.55), p< 0.001.The LLM index from tracheal aspirate appears to rise into a low range after birth. With IV lipid infusion, the LLM index appears to rise to a higher level.
Conclusion: The Lipid Laden Macrophage Index is elevated during Intralipid® infusion. This may interfere with the use of LLM index as a marker of milk aspiration in neonates receiving IV lipids.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kajetanowicz, A., Stinson, D. Lipid laden macrophages in tracheal aspirates of neonates receiving Intralipid®. 1860. Pediatr Res 39 (Suppl 4), 313 (1996). https://doi.org/10.1203/00006450-199604001-01884
Issue Date:
DOI: https://doi.org/10.1203/00006450-199604001-01884