Document Detail

Surfactant kinetics in preterm infants on mechanical ventilation who did and did not develop bronchopulmonary dysplasia.
MedLine Citation:
PMID:  12771629     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To characterize surfactant kinetics in vivo in two groups of premature infants on different levels of mechanical ventilation and at different risk of developing bronchopulmonary dysplasia. DESIGN: Controlled observational study in two independent groups of infants. SETTING: Neonatal intensive care unit. PATIENTS: Thirteen preterm infants (26 +/- 0.5 wks, birth weight 801 +/- 64 g) on high ventilatory setting and who finally all developed bronchopulmonary dysplasia (MechVentBPD), and eight (26 +/- 0.5 wks, birth weight 887 +/- 103 g) who had minimal or no lung disease and of whom none developed bronchopulmonary dysplasia (MechVentNoBPD). MEASUREMENTS AND MAIN RESULTS: Endotracheal 13C-labeled dipalmitoyl-phosphatidylcholine was administered and subsequent measurements of the 13C enrichment of surfactant-disaturated phosphatidylcholine (DSPC) from serial tracheal aspirates were made by gas chromatography-mass spectrometry. We calculated disaturated phosphatidylcholine pharmacokinetic variables in terms of half-life and apparent pool size from the enrichment decay curves over time. DSPC concentration from tracheal aspirates was expressed as milligrams/milliliter epithelial lining fluid (ELF-DSPC). Data are presented as mean +/- se. In MechVentBPD infants vs. MechVentNoBPD, ELF-DSPC was much reduced, 2.9 +/- 0.6 vs. 9.4 +/- 3.0 mg/mL ELF (p =.03), half-life was shorter, 19.4 +/- 2.8 vs. 42.5 +/- 6.3 hrs (p =.002), and apparent pool size larger, 136 +/- 21 vs. 65.8 +/- 16.0 mg/kg (p =.057). In MechVentBPD, apparent DSPC pool size positively correlated with mean airway pressure x Fio(2) and inversely correlated with ELF-DSPC. ELF-DSPC was inversely correlated with mean airway pressure x Fio(2). No significant correlations were found in the MechVentNoBPD group. CONCLUSIONS: MechVentBPD infants showed profound alteration of surfactant kinetics compared with preterm infants with minimal lung disease, and these alterations were correlated with severity of ventilatory support.
Paola E Cogo; Luc J I Zimmermann; Roberta Pesavento; Elisabetta Sacchetto; Aldo Burighel; Federica Rosso; Tamara Badon; Giovanna Verlato; Virgilio P Carnielli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-28     Completed Date:  2003-06-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1532-8     Citation Subset:  AIM; IM    
Department of Pediatrics, University of Padova, Italy.
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MeSH Terms
1,2-Dipalmitoylphosphatidylcholine / administration & dosage,  pharmacokinetics
Airway Resistance
Birth Weight
Bronchopulmonary Dysplasia / classification,  etiology*,  metabolism*,  physiopathology
Carbon Isotopes / analysis,  pharmacokinetics
Case-Control Studies
Gas Chromatography-Mass Spectrometry
Gestational Age
Infant, Newborn
Instillation, Drug
Phosphatidylcholines / analysis
Pulmonary Surfactants / metabolism*
Regression Analysis
Respiration, Artificial / adverse effects*
Risk Factors
Severity of Illness Index
Sputum / chemistry
Time Factors
Reg. No./Substance:
0/Carbon Isotopes; 0/Phosphatidylcholines; 0/Pulmonary Surfactants; 2644-64-6/1,2-Dipalmitoylphosphatidylcholine

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