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Ultrastructure and mucociliary transport of bronchial respiratory epithelium in intubated patients

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Abstract

Objective

The objective of this study was to investigate whether reduced bronchial mucus transport velocity (BTV) is associated with a loss of cilia or ultrastructural abnormalities of cilia in intubated patients.

Design

The patients were studied prospectively in a convenience sample trial.

Setting

The study took place in a university hospital.

Patients and participants

29 orally intubated patients in a surgical ICU.

Interventions

BTV was measured with radiolabeled microspheres in the right and left primary bronchus. Following these measurements, biopsy samples were taken from the bronchi for scanning (SEM) and transmission (TEM) electron-microscopic investigations.

Measurements and results

SEM: Patients with normal or slight impaired BTV (group 1,n=14: BTV: 8.5 mm/min (3.8–11.5); median with range) showed more cilia on the luminal surface than patients with markedly depressed BTV (p<0.05) (group 2,n=15: BTV: 0(0–2.1)). The difference was statistically significant. The BTV values correlated moderately with the number of cilia on the luminal surface (r=0.46;p=0.02). TEM: In group 1, 6.5% (3.9–14.9) of cilia were abnormal (median with range) vs 9.3% (4.9–13.7) in group 2; these differences were not statistically significant. Neither was there any significant correlation between BTV and the frequency of abnormal cilia.

Conclusions

Impaired mucociliary transport in intubated patients is associated with a loss of cilia rather than ultrastructural abnormalities of cilia, which are less relevant.

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Authors and Affiliations

  1. Klinikum der Universität Ulm, Universitätsklinik für Anaesthesiologie, Steinhövelstrasse 9, D-89075, Ulm, Germany

    F. Konrad, R. Schiener, T. Marx & M. Georgieff

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  1. F. Konrad
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  2. R. Schiener
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  3. T. Marx
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  4. M. Georgieff
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Konrad, F., Schiener, R., Marx, T. et al. Ultrastructure and mucociliary transport of bronchial respiratory epithelium in intubated patients. Intensive Care Med 21, 482–489 (1995). https://doi.org/10.1007/BF01706201

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  • DOI: https://doi.org/10.1007/BF01706201

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