Document Detail

Phospholipid and surfactant protein A concentrations in tracheal aspirates from infants requiring extracorporeal membrane oxygenation.
MedLine Citation:
PMID:  1640296     Owner:  NLM     Status:  MEDLINE    
To test the hypothesis that infants with severe respiratory failure and the need for extracorporeal membrane oxygenation (ECMO) are surfactant deficient, we measured the amount of surfactant phospholipids, disaturated phosphatidylcholine, surfactant protein A, and protein in tracheal aspirates from 22 infants, who received ECMO therapy for respiratory failure with meconium aspiration syndrome (n = 18) or pneumonia (n = 4). Tracheal suction material was obtained in a standardized way every 4 hours during the period of ECMO treatment and pooled for 24-hour periods. During ECMO, mean total phospholipid, disaturated phosphatidylcholine, and surfactant protein A values in tracheal aspirates increased and protein values decreased significantly, predominantly during the 72-hour period before infants were weaned from ECMO. Of the 22 infants, 14 had an increase in tracheal aspirate phospholipid values of more than 200% and were found to need a shorter period of ECMO support (p less than 0.005) and post-ECMO ventilatory support (p less than 0.025) than did the eight infants with stationary or only moderate increases in tracheal aspirate phospholipid values, three of whom had pneumonia. We conclude that infants with respiratory failure who require ECMO treatment often have surfactant deficiency. We speculate that surfactant treatment might decrease the need for or the duration of ECMO support.
K C Bui; F J Walther; R David-Cu; M Garg; D Warburton
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  121     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-03     Completed Date:  1992-09-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  271-4     Citation Subset:  AIM; IM    
Division of Neonatology and Pediatric Pulmonology Children's Hospital of Los Angles, University of Southern California School of Medicine.
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MeSH Terms
Extracorporeal Membrane Oxygenation*
Glycoproteins / analysis*
Infant, Newborn
Meconium Aspiration Syndrome / complications
Phospholipids / analysis*
Pneumonia / complications
Proteolipids / analysis*
Pulmonary Surfactant-Associated Proteins
Pulmonary Surfactants / analysis*
Respiratory Insufficiency / etiology,  metabolism*,  therapy
Trachea / secretion*
Grant Support
Reg. No./Substance:
0/Glycoproteins; 0/Phospholipids; 0/Proteolipids; 0/Pulmonary Surfactant-Associated Proteins; 0/Pulmonary Surfactants

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