Document Detail

Surfactant phosphatidylcholine metabolism in neonates with meconium aspiration syndrome.
MedLine Citation:
PMID:  17095334     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  149     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-10     Completed Date:  2007-01-04     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  634-9     Citation Subset:  AIM; IM    
Erasmus MC-Sophia, Division of Neonatology and Pediatric Surgery, Rotterdam, The Netherlands.
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MeSH Terms
Analysis of Variance
Case-Control Studies
Combined Modality Therapy
Extracorporeal Membrane Oxygenation*
Glucose / administration & dosage,  analogs & derivatives
Infant, Newborn
Infusions, Intravenous
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
Reg. No./Substance:
0/Palmitic Acids; 0/Phosphatidylcholines; 0/Pulmonary Surfactants; 50-99-7/Glucose; 57-13-6/Urea; 5962-14-1/glucosylurea

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