Document Detail

Onset of mechanical ventilation is associated with rapid activation of circulating phagocytes in preterm infants.
MedLine Citation:
PMID:  16452365     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In preterm infants with respiratory distress syndrome (RDS), circulating neutrophils are activated. Kinetics and effects of surfactant therapy on this activation are unknown. Therefore, we studied activation of circulating neutrophils and monocytes in newborn preterm infants with and without RDS. PATIENTS AND METHODS: Preterm infants with RDS who were mechanically ventilated and received surfactant ("ventilated infants": n = 38; mean gestational age +/- SD: 28.3 +/- 2.2 weeks; mean birth weight +/- SD: 1086 +/- 353 g) and preterm infants who received nasal continuous positive airway pressure (n = 8) or no ventilatory support (n = 17) ("control infants": mean gestational age +/- SD: 32.1 +/- 1.2 weeks; mean birth weight +/- SD: 1787 +/- 457 g) were recruited. Blood samples were taken from ventilated infants at birth, before surfactant treatment, at 1 and 2 hours after surfactant, and at 12 to 24 hours of age. Blood samples were taken from control infants at birth, at 2 to 6 hours, and at 12 to 24 hours of age. Phagocyte CD11b expression was analyzed by flow cytometry. RESULTS: In ventilated infants, phagocyte CD11b expression increased from birth to the first postnatal samples. It increased further by 12 to 24 hours of age. Control infants with or without nasal continuous positive airway pressure showed no significant increase after birth. At 12 to 24 hours of age, phagocyte CD11b expression was higher in ventilated infants than in control infants. In ventilated infants, neutrophil CD11b expression at 1 and 2 hours after surfactant correlated positively with gestational age. CONCLUSIONS: In preterm infants with RDS, significant activation of circulating phagocytes occurs within 1 to 3 hours of the onset of mechanical ventilation, independent of surfactant administration, which indicates that mechanical ventilation may be the inducer of this systemic inflammatory response.
Riikka Turunen; Irmeli Nupponen; Sanna Siitonen; Heikki Repo; Sture Andersson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  117     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-02     Completed Date:  2006-02-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  448-54     Citation Subset:  AIM; IM    
Hospital for Children and Adolescents, Helsinki, Finland.
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MeSH Terms
Antigens, CD11b / analysis
Continuous Positive Airway Pressure*
Infant, Newborn
Infant, Premature
Monocytes / immunology
Neutrophils / immunology
Phagocytes / immunology,  physiology*
Pulmonary Surfactants / therapeutic use*
Respiratory Distress Syndrome, Newborn / physiopathology*,  therapy
Reg. No./Substance:
0/Antigens, CD11b; 0/Pulmonary Surfactants

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