Inhibitory effect of meconium on pulmonary surfactant function tested in vitro using the stable microbubble test

Abstract

The stable microbubble test is an effective indirect method that tests the changes in surfactant quantity. In the in vitro experiment, we observed an inhibitory effect of meconium on the surfactant activity using the stable microbubble test.

Exogenous surfactant therapy in 2013: what is next? who, when and how should we treat newborn infants in the future?

“…Various clinical situations such as pulmonary haemorrhage, meconium aspiration syndrome (MAS), pulmonary infection and atelectasis have been shown to liberate inflammatory mediators that damage type II pneumocytes and inactivate surfactant [20,21]. Surfactant replacement therapy could thus be useful as a supporting treatment in this population of newborns with secondary or transient surfactant deficiency.…”

Effect of meconium on the rate of in vitro subtype conversion of swine pulmonary surfactant

“…The accelerated surfactant subtype conversion in the presence of meconium means the increased consumption of surface-active large and heavy surfactant aggregates. Recent studies [4,18,20,26] have reported the interaction between pulmonary surfactant and human meconium as indicated by delayed adsorption and increased minimum surface tension (i.e. inhibition of biophysical properties of pulmonary surfactant).…”

“…Although the interactions between pulmonary surfactant and meconium have been previously reported [4,5,12,18,20,26], no prior study has paid attention to the eect of meconium on the rate of surfactant subtype conversion (i.e. extracellular surfactant metabolism).…”

“…Meconium-induced lung injury is associated with many pulmonary changes including atelectasis, air leakage, and chemical pneumonitis. Recent data suggest that meconium can aect the biophysical properties of the pulmonary surfactant [4,18,20,26], the metabolism of pulmonary surfactant in type II pneumonocytes [12], and surfactant composition [5].…”

Surfactant phosphatidylcholine metabolism in neonates with meconium aspiration syndrome

“…Meconium inhibits surfactant function directly, and thereby increases the minimum and maximum surface tension in the alveolus, and lowers the spreading rate of surfactant. [1][2][3][4][5] Information on surfactant concentration and composition in MAS is scarce. Bronchoalveolar lavage (BAL) fluid from eight infants with MAS receiving mechanical ventilation had no differences in phospholipid and surfactant protein-A (SP-A) content compared with control subjects.…”