Macroscopic aspect of tracheobronchial secretions from intubated children has no clinical value

This study was set out to address the question of whether the macroscopic appearance of tracheal secretions collected from ventilated patients in a paediatric intensive care unit is related to the results of microscopy and bacteriological culture of the tracheal secretions. Fifty-seven critically ill children requiring intubation were prospectively enrolled. One hundred and sixty six tracheobronchial secretions samples were taken and evaluated macroscopically for colour, consistency and amount. The association between macroscopic aspect and microbiologic analysis, Gram's stain and culture, was evaluated. The only association we found was between colour and the presence of ≥25 leukocytes. Although statistically significant, this association has limited clinical value. All other associations were not statistically significant. Thirty seven percent of all tracheobronchial secretions samples yielded potentially pathogenic micro-organisms (PPM) and in 74% of all patients at least one tracheobronchial secretions sample contained PPM. There is no correlation between the macroscopic appearance of tracheobronchial secretions and the results of bacteriological culture. The macroscopic aspect of tracheobronchial secretions has therefore no value.