| Surfactant phosphatidylcholine metabolism in neonates with meconium aspiration syndrome. | |
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MedLine Citation:
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PMID: 17095334 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Because meconium directly inhibits surfactant function, we sought to determine the effect of meconium on endogenous surfactant synthesis and clearance. STUDY DESIGN: We studied surfactant phosphatidylcholine kinetics with the use of stable isotopes in 11 newborn infants with meconium aspiration syndrome (MAS) who required extracorporeal membrane oxygenation (ECMO). For comparison we studied 6 neonates with persistent pulmonary hypertension (PPHN) on ECMO and 10 term neonates ventilated for non-pulmonary indications and not on ECMO. All patients received a 24-hour [U- 13C]glucose infusion as precursor for the palmitic acid in surfactant phosphatidylcholine. RESULTS: In the meconium group, the maximal 13C-incorporation in phosphatidylcholine (PC) was half of that in controls (0.09 +/- 0.01 vs 0.18 +/- 0.03 atom percent excess [APE], P = .027). There was a trend toward lower surfactant synthesis in the MAS group (3.3 +/- 0.7%/day) and PPHN group (2.6 +/- 0.3%/day) compared with controls 8.0 +/- 2.4%/day, P = .058). Significantly lower PC concentrations in tracheal aspirates were found in the MAS group (4.4 +/- 2.6 mg/mL) and PPHN group (3.6 +/- 2.0 mg/mL) compared with controls (12.8 +/- 2.6 mg/mL, P = .01). Endogenously synthesized surfactant had a similar half-life in all groups, ranging from 63 to 98 hours. CONCLUSION: We conclude that surfactant synthesis is disturbed and that surfactant PC concentrations are low in infants with MAS on ECMO. |
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Authors:
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Daphne J Janssen; Virgilio P Carnielli; Paola Cogo; Kajsa Bohlin; Aaron Hamvas; Ingrid H Luijendijk; Jan Erik H Bunt; Dick Tibboel; Luc J Zimmermann |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of pediatrics Volume: 149 ISSN: 0022-3476 ISO Abbreviation: J. Pediatr. Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-11-10 Completed Date: 2007-01-04 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 634-9 Citation Subset: AIM; IM |
Affiliation:
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Erasmus MC-Sophia, Division of Neonatology and Pediatric Surgery, Rotterdam, The Netherlands. daphnejanssen@planet.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Case-Control Studies Combined Modality Therapy Extracorporeal Membrane Oxygenation* Female Glucose / administration & dosage, analogs & derivatives Half-Life Humans Infant, Newborn Infusions, Intravenous Male Meconium Aspiration Syndrome / metabolism*, physiopathology, therapy Palmitic Acids / metabolism Persistent Fetal Circulation Syndrome / metabolism Phosphatidylcholines / metabolism*, therapeutic use* Pulmonary Surfactants / metabolism*, therapeutic use* Respiration, Artificial Time Factors Trachea / metabolism Treatment Outcome Urea / administration & dosage, analogs & derivatives, blood |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL 65385/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Palmitic Acids; 0/Phosphatidylcholines; 0/Pulmonary Surfactants; 50-99-7/Glucose; 57-13-6/Urea; 5962-14-1/glucosylurea |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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