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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Predicting respiratory distress syndrome at birth using fast test based on spectroscopy of gastric aspirates. 1. Biochemical part

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AIM: To develop a fast bedside lung maturity test.

METHODS: Gastric aspirates obtained from premature infants, contain lamellar bodies, carrying lung surfactant. To estimate lung maturity we isolated lamellar bodies from fresh gastric aspirates by centrifugation. Erythrocytes and other cells were lysed by adding water and discarded subsequently with the supernatant. Mid-infrared spectroscopy was then performed to measure the lung maturity as lecithin-sphingomyelin ratio. Lecithin was determined as dipalmitoylphosphatidylcholine, the most surface-active-phospholipid. Algorithms to measure lecithin and sphingomyelin concentrations in fresh gastric aspirates were developed on aspirates from 140 premature infants. Each gastric aspirate sample was divided in two samples: one for mass spectrometry as reference and one for spectroscopy. Development of the algorithm is described in details in Appendix S1.

RESULTS: Gastric aspirates stored at 4-5°C avoid flocculation of proteins and phospholipids in contrast to when the aspirates were frozen and thawed. Omission of freezing and concentration of the lung surfactant by centrifugation combined with diminished influence of proteins improves the spectroscopic measurement of lecithin-sphingomyelin ratio. Measurement of lecithin-sphingomyelin ratio by the new method was performed within 10-15 minutes.

CONCLUSION: We present a new fast bedside lung maturity test on fresh gastric aspirate for early targeted surfactant treatment. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalActa paediatrica
ISSN1651-2227
DOIs
Publication statusE-pub ahead of print - 14 Jun 2019

ID: 57375948