Pulmonary fluid content in infants with respiratory distress

Desa, D. J.

doi:10.1002/path.1710970306

Cited by 54 publications

(8 citation statements)

References 28 publications

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“…However, excess of pulmonary liquid may adversely contribute to the disease. It has previously been shown in stillborn fetuses that pulmonary fluid content is higher in immature fetuses compared to fetuses 12,500 g. Also, babies who died of respiratory distress during the first few hours of life had not been able to reduce lung water compared to those who survived beyond 48 h [15]. In addition to the primary problem of excess lung water content an increased permeability of the alveolar capillary membrane seems to be important in prolonging respiratory distress of the premature infant [16].…”

Section: Observations On Human Patientsmentioning

confidence: 98%

Lung Epithelial Ion Transport in Neonatal Lung Disease

Pitkänen

2001

Neonatology

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Lung epithelial ion transport promotes salt and water movement across the fetal and neonatal lung epithelium. The mechanism is dependent on basolateral membrane Na-K-ATPase and the apical membrane Cl^– and Na⁺ channels. During fetal life active secretion of Cl^– and parallel movement of Na⁺ across the epithelium into the developing lung lumen induce accumulation of liquid into the future airspaces. Postnatally, however, absorption of fluid from the airspaces must start. Present evidence suggests that activation of Na⁺ transport from the lumen into the basolateral direction drives fluid absorption and results in an essentially dry air-filled alveolus. In laboratory animals amiloride, a Na⁺ channel blocker, induces respiratory distress and impedes lung fluid clearance. One of the epithelial amiloride-sensitive Na⁺ channels, ENaC, is composed of three homologous subunits that differentially respond to glucocorticoid hormone. In newborn infants an increase in pulmonary fluid and a defective Na⁺ transport associate with respiratory distress. The ontogeny, subunit composition and function of ENaC along the respiratory tract are currently under investigation. It will be interesting to find out whether the subunit composition and function of lung ENaC respond to the therapy of the critically ill newborn infant.

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Section: Observations On Human Patientsmentioning

confidence: 98%

Lung Epithelial Ion Transport in Neonatal Lung Disease

Pitkänen

2001

Neonatology

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“…Pulmonary edema is a consistent feature of the lung pathology associated with respiratory distress after premature birth (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Lung fluid balance in lambs before and after premature birth.

Bland¹,

Carlton²,

Scheerer³

et al. 1989

J. Clin. Invest.

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“…Compared with preterm babies without neonatal lung disease, those with RDS have an increased lung liquid content (6,7).…”

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confidence: 99%

Electrical Potential Difference Across the Nasal Epithelium Is Reduced in Premature Infants With Chronic Lung Disease but Is Not Associated With Lower Airway Inflammation

et al. 2007

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Airway liquid content and insufficient absorptive airway ion transport at birth are potentially important factors in the development and severity of neonatal respiratory disease. The role of deficient absorptive airway ion transport in the development of chronic lung disease of prematurity is unknown. Additionally, lung inflammatory mediators modulate airway ion transport. Their effect on preterm lung ion transport and absorptive capacity is not established. We performed serial nasal potential difference studies and broncho-alveolar lavage in preterm infants born less than 30 wk postmenstrual age over the first four postnatal weeks. Our study aims were to: 1) compare nasal potential difference between preterm infants developing chronic lung disease and babies of similar gestation who do not; and 2) examine for an association between airway inflammation and ion transport parameters. We found that potential difference across the nasal epithelium increased with gestation, remained low and unchanged in infants developing chronic lung disease over the first four postnatal weeks, was significantly lower at four weeks in chronic lung disease infants, and was not associated with lower airway inflammation at any time point. We conclude that infants with chronic lung disease postnatally have a persistently reduced absorptive airway ion transport capacity. (Pediatr Res 61: 77-82, 2007) T he incidence of chronic lung disease of prematurity (CLD) in very preterm infants has not changed significantly over the last decade despite the routine administration of antenatal steroids and postnatal exogenous surfactant (1,2).A greater residual airway liquid content resulting from incompletely developed absorptive airway ion transport processes at birth is a potentially important factor in the pathogenesis and severity of the neonatal respiratory distress syndrome (RDS) (3-5). Compared with preterm babies without neonatal lung disease, those with RDS have an increased lung liquid content (6,7).Lung inflammation is present in preterm infants with RDS (8,9). Those who develop CLD experience a persistent and greater lung inflammatory response (10,11).Recent studies have demonstrated that inflammatory mediators influence airway ion transport processes (12-16). However, in vitro studies have given conflicting results with respect to the effect of cytokines on airway ion transport processes. Interleukin (IL)-4 and interferon-␥ inhibit the amiloride sensitive epithelial sodium channel (ENaC) (12,13) in polarized cultured human bronchial epithelial cells whereas tumor necrosis factor (TNF)-␣ was not found to modulate ion transport (13). In vivo experiments have demonstrated a TNF-␣ (14), IL-1␤ (15) and TGF-␣ (16) mediated increase in lung liquid absorption. These studies were conducted with single cytokines in models of mature lung epithelium. There are no data on the impact of cytokines on the airway ion transport processes of the human newborn lung in vivo.The aim of this study was to examine in vivo the association between cytoki...

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Pulmonary fluid content in infants with respiratory distress

Cited by 54 publications

References 28 publications

Lung Epithelial Ion Transport in Neonatal Lung Disease

Lung Epithelial Ion Transport in Neonatal Lung Disease

Lung fluid balance in lambs before and after premature birth.

Electrical Potential Difference Across the Nasal Epithelium Is Reduced in Premature Infants With Chronic Lung Disease but Is Not Associated With Lower Airway Inflammation

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