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Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity

Verder, Henrik; Heiring, Christian; Clark, Howard; Sweet, David; Jessen, Torben E.; Ebbesen, Finn; Björklund, Lars J. LU ; Andreasson, Bengt; Bender, Lars and Bertelsen, Aksel, et al. (2017) In Acta Paediatrica, International Journal of Paediatrics 106(3). p.430-437
Abstract

Aim: Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear, it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation. Methods: Concentrations of the most surface-active lung phospholipid dipalmitoylphosphatidylcholine and sphingomyelin in gastric aspirates from premature infants were measured by mass spectrometry and expressed as the lecithin/sphingomyelin ratio (L/S). The same aspirates were analysed with mid-infrared spectroscopy. Subsequently, L/S was measured in gastric aspirates and oropharyngeal secretions from another... (More)

Aim: Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear, it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation. Methods: Concentrations of the most surface-active lung phospholipid dipalmitoylphosphatidylcholine and sphingomyelin in gastric aspirates from premature infants were measured by mass spectrometry and expressed as the lecithin/sphingomyelin ratio (L/S). The same aspirates were analysed with mid-infrared spectroscopy. Subsequently, L/S was measured in gastric aspirates and oropharyngeal secretions from another group of premature infants using spectroscopy and the results were compared with RDS development. The 10-minute analysis required 10 μL of aspirate. Results: An L/S algorithm was developed based on 89 aspirates. Subsequently, gastric aspirates were sampled in 136 infants of 24-31 weeks of gestation and 61 (45%) developed RDS. The cut-off value of L/S was 2.2, sensitivity was 92%, and specificity was 73%. In 59 cases, the oropharyngeal secretions had less valid L/S than gastric aspirate results. Conclusion: Our rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted RDS with high sensitivity.

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publication status
published
subject
keywords
Gastric aspirate, Lung surfactant, Mid-infrared spectroscopy, Prematurity, Respiratory distress syndrome
in
Acta Paediatrica, International Journal of Paediatrics
volume
106
issue
3
pages
430 - 437
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • scopus:85007374799
  • wos:000397404700017
ISSN
0803-5253
DOI
10.1111/apa.13683
language
English
LU publication?
yes
id
06bf9518-2e4e-4bef-b1e4-0e9bb5c7443d
date added to LUP
2017-01-20 13:19:48
date last changed
2018-01-07 11:45:55
@article{06bf9518-2e4e-4bef-b1e4-0e9bb5c7443d,
  abstract     = {<p>Aim: Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear, it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation. Methods: Concentrations of the most surface-active lung phospholipid dipalmitoylphosphatidylcholine and sphingomyelin in gastric aspirates from premature infants were measured by mass spectrometry and expressed as the lecithin/sphingomyelin ratio (L/S). The same aspirates were analysed with mid-infrared spectroscopy. Subsequently, L/S was measured in gastric aspirates and oropharyngeal secretions from another group of premature infants using spectroscopy and the results were compared with RDS development. The 10-minute analysis required 10 μL of aspirate. Results: An L/S algorithm was developed based on 89 aspirates. Subsequently, gastric aspirates were sampled in 136 infants of 24-31 weeks of gestation and 61 (45%) developed RDS. The cut-off value of L/S was 2.2, sensitivity was 92%, and specificity was 73%. In 59 cases, the oropharyngeal secretions had less valid L/S than gastric aspirate results. Conclusion: Our rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted RDS with high sensitivity.</p>},
  author       = {Verder, Henrik and Heiring, Christian and Clark, Howard and Sweet, David and Jessen, Torben E. and Ebbesen, Finn and Björklund, Lars J. and Andreasson, Bengt and Bender, Lars and Bertelsen, Aksel and Dahl, Marianne and Eschen, Christian and Fenger-Grøn, Jesper and Hoffmann, Stine F. and Höskuldsson, Agnar and Bruusgaard-Mouritsen, Maria and Lundberg, Fredrik and Postle, Anthony D. and Schousboe, Peter and Schmidt, Peter and Stanchev, Hristo and Sørensen, Lars},
  issn         = {0803-5253},
  keyword      = {Gastric aspirate,Lung surfactant,Mid-infrared spectroscopy,Prematurity,Respiratory distress syndrome},
  language     = {eng},
  number       = {3},
  pages        = {430--437},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Paediatrica, International Journal of Paediatrics},
  title        = {Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity},
  url          = {http://dx.doi.org/10.1111/apa.13683},
  volume       = {106},
  year         = {2017},
}