Document Detail


Pulmonary surfactant kinetics of the newborn infant: novel insights from studies with stable isotopes.
MedLine Citation:
PMID:  19399007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Deficiency or dysfunction of the pulmonary surfactant plays a critical role in the pathogenesis of respiratory diseases of the newborn. After a short review of the pulmonary surfactant, including its role in selected neonatal respiratory conditions, we describe a series of studies conducted by applying two recently developed methods to measure surfactant kinetics. In the first set of studies, namely 'endogenous studies', which used stable isotope-labeled intravenous surfactant precursors, we have shown the feasibility of measuring surfactant synthesis and kinetics in infants using several metabolic precursors, including plasma glucose, plasma fatty acids and body water. In the second set of studies, namely 'exogenous studies', which used a stable isotope-labeled phosphatidylcholine (PC) tracer given endotracheally, we estimated the surfactant disaturated phosphatidylcholine (DSPC) pool size and half-life. The major findings of our studies are presented here and can be summarized as follows: (a) the de novo synthesis and turnover rates of the surfactant (DSPC) in preterm infants with respiratory distress syndrome (RDS) are very low with either precursor; (b) in preterm infants with RDS, pool size is very small and half-life much longer than what has been reported in animal studies; (c) patients recovering from RDS who required higher continuous positive airway pressure pressure after extubation or reintubation have a lower level of intrapulmonary surfactant than those who did well after extubation; (d) term newborn infants with pneumonia have greatly accelerated surfactant catabolism; and (e) infants with uncomplicated congenital diaphragmatic hernia (CDH) and on conventional mechanical ventilation have normal surfactant synthesis, but those requiring extracorporeal membrane oxygenated (ECMO) do not. Information obtained from these studies in infants will help to better tailor exogenous surfactant treatment in neonatal lung diseases.
Authors:
V P Carnielli; L J I Zimmermann; A Hamvas; P E Cogo
Related Documents :
12148967 - Community-acquired pseudomonas aeruginosa pneumonia complicated with loculated empyema ...
15173537 - Early extubation and nasal continuous positive airway pressure after surfactant treatme...
14654627 - Revised indications for the use of palivizumab and respiratory syncytial virus immune g...
11747257 - Aspiration: a factor in rapidly deteriorating bronchiolitis in previously healthy infants?
10879307 - Neonatal lupus erythematosus.
9138637 - Paracetamol overdose in pregnancy analysis of the outcomes of 300 cases referred to the...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  29 Suppl 2     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-28     Completed Date:  2009-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S29-37     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Department of Clinical Sciences, Salesi Hospital, Polytechnic University of Marche, Ancona, Italy. v.carnielli@univpm.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage,  adverse effects
Extracorporeal Membrane Oxygenation
Hernia, Diaphragmatic / congenital,  drug therapy,  physiopathology
Humans
Infant, Newborn
Isotopes / diagnostic use,  pharmacokinetics
Meconium Aspiration Syndrome / drug therapy,  physiopathology
Pulmonary Alveoli / drug effects,  physiopathology
Pulmonary Surfactants / administration & dosage,  adverse effects,  chemistry,  pharmacokinetics*
Respiration, Artificial
Respiratory Distress Syndrome, Newborn / drug therapy,  physiopathology*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Isotopes; 0/Pulmonary Surfactants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Synthetic surfactants: where are we? Evidence from randomized, controlled clinical trials.
Next Document:  Animal-derived surfactants: where are we? The evidence from randomized, controlled clinical trials.