Document Detail

Endogenous surfactant metabolism in critically ill infants measured with stable isotope labeled fatty acids.
MedLine Citation:
PMID:  10022597     Owner:  NLM     Status:  MEDLINE    
Little is known about endogenous surfactant metabolism in infants, because radioactive isotopes used for this purpose in animals cannot be used in humans. We developed a novel and safe method to measure the endogenous surfactant kinetics in vivo in humans by using stable isotope labeled fatty acids. We infused albumin-bound [U-13C]palmitic acid (PA) and [U-13C]linoleic acid (LLA) for 24 h in eight critically ill infants (mean+/-SD: weight: 3.7+/-1.3 kg: age: 51.3+/-61.6 d) who required mechanical ventilation. The 13C enrichment of PA and LLA in surfactant phosphatidylcholine (PC), obtained from tracheal aspirates, was measured by gas chromatography combustion interface-isotope ratio mass spectrometry. We measured a significant incorporation of both 13C-PA and 13C-LLA into surfactant PC. PC-PA and PC-LLA became enriched after 8.7+/-4.9 h (range: 3.4-17.3) and 10.0+/-7.2 h (range: 3.0-22.4), respectively; the times at maximum enrichment were 49.2+/-8.9 and 45.6+/-19.3 h, respectively. The fractional synthesis rate of surfactant PC-PA ranged from 0.4 to 3.4% per h, whereas the fractional synthesis rate of PC-LLA ranged from 0.5 to 3.8% per h. The surfactant PC-PA and PC-LLA half-lives ranged from 16.8 to 177.7 and 23.8 to 144.4 h, respectively. This method provides new data on surfactant metabolism in infants requiring mechanical ventilation. We found that synthesis of surfactant from plasma PA and LLA is a slow process and that there were marked differences in PC kinetics among infants. This variability could be related to differences in lung disease and could affect the clinical course of the respiratory failure.
P E Cogo; V P Carnielli; J E Bunt; T Badon; G Giordano; F Zacchello; P J Sauer; L J Zimmermann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric research     Volume:  45     ISSN:  0031-3998     ISO Abbreviation:  Pediatr. Res.     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-04-16     Completed Date:  1999-04-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  242-6     Citation Subset:  IM    
Department of Paediatrics, University of Padua, Italy.
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MeSH Terms
Carbon Isotopes
Critical Illness*
Energy Intake
Infant, Newborn
Infusions, Intravenous
Linoleic Acid / administration & dosage,  metabolism*
Palmitic Acid / administration & dosage,  metabolism*
Phosphatidylcholines / metabolism*
Protein Binding
Pulmonary Surfactants / metabolism*
Serum Albumin
Specimen Handling / methods
Time Factors
Reg. No./Substance:
0/Carbon Isotopes; 0/Phosphatidylcholines; 0/Pulmonary Surfactants; 0/Serum Albumin; 2197-37-7/Linoleic Acid; 57-10-3/Palmitic Acid

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