Lipid‐Laden Macrophage Index as a Diagnostic Tool for Pediatric Aspiration: A Systematic Review

• Published in: OTO open : the official open access journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation Vol. 7; no. 1; pp. e33 - n/a
• Main Authors: Lawlor, Claire M., Choi, Sukgi S.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2023; John Wiley and Sons Inc; Wiley
• Subjects: aspiration; bronchoalveolar lavage; Children & youth; Data collection; Disease; Food; Gastroesophageal reflux; Hospitals; Lipids; lipid‐laden macrophages; Medical diagnosis; Observational studies; Patients; Pediatrics; Pulmonary aspiration; Systematic review; Systematic Review with or without Meta‐analysis; United States > US; Mexico; bronchoalveolar lavage; lipid‐laden macrophages; aspiration
• ISSN: 2473-974X; 2473-974X
• DOI: 10.1002/oto2.33

Objective Lipid‐laden macrophage index (LLMI) has been proposed as a marker for aspiration on bronchoalveolar lavage. It has also been studied as a marker for gastroesophageal reflux and other pulmonary diseases. This review aims to determine the clinical correlation between LLMI and pediatric aspiration. Data Sources PubMed (MeSH search), Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) portals through December 17th, 2020. Review Methods Preferred Reporting Items for Systematic Review and Meta‐Analysis criteria were followed, and a quality assessment of included studies was performed using the Methodological Index for Non‐Randomized Studies. Search criteria included all occurrences in the title or of the terms “pulmonary aspiration” and “alveolar macrophages.” Results Five studies describing 720 patients met inclusion, 3 retrospective case‐control studies, and 2 prospective observational studies. Four studies suggested a link between elevated LLMI and aspiration, and 1 found no association. Control groups varied and included healthy nonaspirators to nonaspirators with other pulmonary diseases. Diagnosis of aspiration was not standardized across the studies. Three papers proposed cutoff values for LLMI, all different. Conclusion The existing literature indicates that LLMI is not a sensitive or specific marker for aspiration. Further study is needed to define the utility of LLMI in pediatric aspiration.