Endogenous pulmonary surfactant metabolism is not affected by mode of ventilation in premature infants with respiratory distress syndrome
| Autor: | Aaron Hamvas, Luc J. I. Zimmermann, Daphne J. Janssen, Virgilio P. Carnielli, Bruce W. Patterson, Kajsa Bohlin, Assaad Merchak |
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| Přispěvatelé: | Pediatrics |
| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_treatment High-Frequency Ventilation Mean airway pressure Pulmonary surfactant Intensive care Medicine Humans Respiratory system Respiratory Distress Syndrome Newborn Lung Respiratory distress business.industry High-frequency ventilation Infant Newborn Pulmonary Surfactants Respiration Artificial Body Fluids medicine.anatomical_structure Anesthesia Pediatrics Perinatology and Child Health Breathing Phosphatidylcholines Female business Infant Premature |
| Zdroj: | Journal of Pediatrics, 140, 693-698. Mosby Inc. |
| ISSN: | 1097-6833 0022-3476 |
| Popis: | To determine if high frequency oscillatory ventilation (HFOV) decreases surfactant production in premature infants with respiratory distress syndrome (RDS).We randomized 19 infants28 weeks of gestation to either HFOV (n = 8) or conventional ventilation (CV, n = 11) at 24 hours of life. After a 24-hour continuous infusion of uniformly labeled carbon 13 glucose (U-(13)C(6)) glucose, we measured (13)C enrichment in surfactant phosphatidylcholine (PC) in tracheal aspirate samples using gas chromatography/mass spectrometry. We calculated the fractional synthetic rate (FSR) of surfactant PC from labeled glucose and its half-life of clearance (T(1/2)).FSR did not differ between groups (4.7% +/- 2.7%/day CV vs 4.2% +/- 3.1%/day HFOV, P =.7). T(1/2) was 79 +/- 18 hours in the CV group and 76 +/- 23 hours in the HFOV group (P =.7). Neither degree of ventilatory support nor supplemental oxygen exposure correlated with surfactant metabolic indices. Three of 4 infants who died from RDS within the first month of life had a shorter T(1/2) than 14 of 15 infants who survived.Surfactant metabolism is similar in preterm infants ventilated with HFOV and CV. Shortened surfactant half-life may characterize a subset of preterm infants with lethal RDS. |
| Databáze: | OpenAIRE |
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