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

Research output: Contribution to journalArticle

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 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.

Details

Authors
  • Henrik Verder
  • Christian Heiring
  • Howard Clark
  • David Sweet
  • Torben E. Jessen
  • Finn Ebbesen
  • Bengt Andreasson
  • Lars Bender
  • Aksel Bertelsen
  • Marianne Dahl
  • Christian Eschen
  • Jesper Fenger-Grøn
  • Stine F. Hoffmann
  • Agnar Höskuldsson
  • Maria Bruusgaard-Mouritsen
  • Fredrik Lundberg
  • Anthony D. Postle
  • Peter Schousboe
  • Peter Schmidt
  • Hristo Stanchev
  • Lars Sørensen
Organisations
External organisations
  • Holbæk Hospital
  • University of Copenhagen
  • Royal Jubilee Maternity Hospital
  • Aalborg University
  • Skåne University Hospital
  • Odense University Hospital
  • Linköping University
  • Southampton General Hospital
  • University of Southampton
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pediatrics

Keywords

  • Gastric aspirate, Lung surfactant, Mid-infrared spectroscopy, Prematurity, Respiratory distress syndrome
Original languageEnglish
Pages (from-to)430-437
JournalActa Paediatrica, International Journal of Paediatrics
Volume106
Issue number3
Publication statusPublished - 2017
Publication categoryResearch
Peer-reviewedYes