Surface Tension Measurements on Pharyngeal and Tracheal Aspirate Samples from Newborns without and with Respiratory Distress Syndrome

Friedrich, Wolfgang; Schmalisch, Gerd; Haufe, M.; Kling, Russell E.; Wauer, Roland R.

doi:10.1159/000244351

Cited by 6 publications

(10 citation statements)

References 11 publications

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“…It has to be taken into consideration that all our patients were in a severe state, the majority being dependent on prolonged artificial respiration, and (for obvious ethical reasons) it is not possible to analyze the TA of healthy infants. Thus, on the basis of the data published by Friedrich et al [15] it may only be presumed that the ST of the TA of less severely pathological patients would be lower.…”

Section: Resultsmentioning

confidence: 99%

“…Our results on the IRDS infants confirmed this. In order to obtain comparable values for the various components in the TA, the reference standard chosen in the present study was the total PL content of the TA, also used by several earlier authors [1,14,15]. It has to be taken into consideration that all our patients were in a severe state, the majority being dependent on prolonged artificial respiration, and (for obvious ethical reasons) it is not possible to analyze the TA of healthy infants.…”

Section: Resultsmentioning

confidence: 99%

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Surface Tension, Glutathione Content and Redox Ratio of the Tracheal Aspirate Fluid of Premature Infants with IRDS

Boda

Németh

Pintér³

1998

Neonatology

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Objective: Determination of the surface tension (ST), the total glutathione (GL) content and the ratio of oxidized glutathione (GSSG) to reduced glutathione (GSH) in the tracheal aspirate (TA) of newborn infants with IRDS. Methods: The ST of the TA was determined by monitoring the fluid level pulsated in a capillary glass tube by means of a digitalized videocomputerized picture analysis program, a technique developed in our laboratory. The concentrations of GSSG and total GL in the TA were determined enzymatically with glutathione reductase. All results of laboratory tests were referred to the total phospholipid (PL) concentration. Patients, Experimental Material: TA samples were collected from 32 intubated premature and newborn infants admitted to the NICU with IRDS during the first 2 weeks of their lives. Control samples were obtained from 11 children prior to elective surgery. Results: The ST relative to the PL content (surface tension index, ST_I) was significantly lower in the newborns with IRDS than in the control group, and the concentration of GSH in the TA was also markedly decreased in all IRDS infants studied. The concentration of GSSG and the ratio of GSSG to GSH were significantly higher in the severe cases and in those with an unfavourable prognosis. Surfactant treatment had a protective effect against oxidative stress, it induced a decrease in both the GSSG concentration and in the GL redox ratio (GSSG/GSH) in the TA. There was a close correlation between the GSH content and the ST_I value of the samples studied. Conclusion: Oxidation and consequent depletion of GSH in the TA may be an aggravating factor in the development of the insufficient surface activity in intubated newborns with IRDS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Surface Tension, Glutathione Content and Redox Ratio of the Tracheal Aspirate Fluid of Premature Infants with IRDS

Boda

Németh

Pintér³

1998

Neonatology

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“…After 8 min of bubble pulsation (rate 20 pulses/min) in the TA, the surface tension Ámin at minimum bubble radius was used for analysis. The reference range (10th and 90th percentile) of surface tension Ámin of TA from babies without pulmonary diseases amounts to (8-29) mN/m with a median of 23 mN/m as previously described [7].…”

Section: Surface Tension Measurementmentioning

confidence: 99%

“…0.01, than the TA of group 2 (RES INS), 18 (1-37) and 37 (4-53) mN/m, respectively. The surface tension values Ámin of group 1 lie mainly under the cutoff value [7] of surface tension measurement on TA: !29 mN/m. Figure 3 relates the MB counts on TA of groups 1 and 2 to the minimal sur- The calculated ROC curves for the MT and the surface tension measurement are depicted in figure 4.…”

Section: Stable Mtmentioning

confidence: 99%

The Stable Microbubble Test on Tracheal Aspirate Samples from Newborn Babies for Diagnosis of Surfactant Deficiency and/or Surfactant Malfunction

Friedrich¹,

Haufe²,

Schmalisch³

et al. 1997

Neonatology

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For predicting the risk of respiratory distress syndrome (RDS), lung surfactant in amniotic fluid can be assessed by observation of stable microbubbles (<15 µm diameter). It was investigated if the stable microbubble test (MT) developed on amniotic fluid could be applied on tracheal aspirate samples (TA) obtained from newborn infants. Forty-four TA from 29 newborn infants without pulmonary diseases (group 1) and 65 TA from 21 newborn infants with respiratory insufficiency (group 2) were analyzed by the MT for predicting surfactant deficiency and/or surfactant malfunction. Ten microbubbles/mm² was defined as cutoff value of the MT. A specificity of 90% and a sensitivity of 52% was obtained with this cutoff value. A much lower rate of false negative results (sensitivity 91%) was noted after surface tension measurement of TA. The sensitivity of the MT (52%) does not encourage the use of the MT on TA.

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“…The lecithin/sphingomyelin (L/ S) ratio is often used to estimate lung maturation and thus to detect surfactant deficiency [8,9]. Measurement of surface tension yields information about surfactant deficiency and dysfunction [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Disturbed Surface Properties in Preterm Infants with Pneumonia

et al. 2001

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Congenital pneumonia in preterm infants is often associated with respiratory insufficiency requiring mechanical ventilation. This study was performed to show whether pneumonia in these infants is associated with an inhibition or deficiency of surfactant. The ratio of lecithin and sphingomyelin (L/S ratio) and minimal surface tension were determined in pharyngeal aspirates from 90 term born infants (healthy) and in tracheal aspirates from preterm infants with wet lung (n = 13), congenital pneumonia (n = 21) and respiratory distress syndrome (RDS) (n = 90). The L/S ratio was lower (p < 0.0001) in the RDS group (8.6) when compared with healthy (48.6), wet lung (42.9) and pneumonia (28.9). Surface tension was higher (p < 0.001) in RDS (37 mN/m) and pneumonia (33.7) when compared with healthy (22.9) or wet lung (21.2). For infants with RDS, L/S ratio <16.5 detects surfactant deficiency with 96% specificity and 70% sensitivity, surface tension >29 mN/m represents surfactant inhibition (specificity 97%, sensitivity 92%). Using these cut-off values in infants with pneumonia, 81% had a sufficient amount of surfactant but only 21% of infants with pneumonia had appropriate surface tension. Our study shows that lung effluent of respiratory insufficient infants with pneumonia, who need mechanical ventilation, has disturbed surface properties despite a sufficient amount of surfactant. In these infants, surfactant substitution could be beneficial.

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Surface Tension Measurements on Pharyngeal and Tracheal Aspirate Samples from Newborns without and with Respiratory Distress Syndrome

Cited by 6 publications

References 11 publications

Surface Tension, Glutathione Content and Redox Ratio of the Tracheal Aspirate Fluid of Premature Infants with IRDS

Surface Tension, Glutathione Content and Redox Ratio of the Tracheal Aspirate Fluid of Premature Infants with IRDS

The Stable Microbubble Test on Tracheal Aspirate Samples from Newborn Babies for Diagnosis of Surfactant Deficiency and/or Surfactant Malfunction

Disturbed Surface Properties in Preterm Infants with Pneumonia

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