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Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity

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  • Henrik Verder
  • Christian Heiring
  • Howard Clark
  • David Sweet
  • Torben E Jessen
  • Finn Ebbesen
  • Lars J Björklund
  • Bengt Andreasson
  • Lars Bender
  • Aksel Bertelsen
  • Marianne Dahl
  • Christian Eschen
  • Jesper Fenger-Grøn
  • Stine F. Hoffmann
  • Agnar Höskuldsson
  • Maria Bruusgaard-Mouritsen
  • Fredrik Lundberg
  • Anthony D Postle
  • Schmidt Peter
  • Hristo Stanchev
  • Lars Sørensen
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AIM: Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear, it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation.

METHODS: Concentrations of the most surface-active lung phospholipid dipalmitoylphosphatidylcholine and sphingomyelin in gastric aspirates from premature infants were measured by mass spectrometry and expressed as the lecithin/sphingomyelin ratio (L/S). The same aspirates were analysed with mid-infrared spectroscopy. Subsequently, L/S was measured in gastric aspirates and oropharyngeal secretions from another group of premature infants using spectroscopy and the results were compared with RDS development. The 10-minute analysis required 10 μL of aspirate.

RESULTS: An L/S algorithm was developed based on 89 aspirates. Subsequently, gastric aspirates were sampled in 136 infants of 24-31 weeks of gestation and 61 (45%) developed RDS. The cut-off value of L/S was 2.2, sensitivity was 92%, and specificity was 73%. In 59 cases, the oropharyngeal secretions had less valid L/S than gastric aspirate results.

CONCLUSION: Our rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted RDS with high sensitivity.

OriginalsprogEngelsk
TidsskriftActa paediatrica
Vol/bind106
Udgave nummer3
Sider (fra-til)430-437
ISSN0803-5253
DOI
StatusUdgivet - 1 mar. 2017

ID: 49634874