Endogenous pulmonary surfactant metabolism is not affected by mode of ventilation in premature infants with respiratory distress syndrome

Assaad Merchak, Daphne J. Janssen, Kajsa Bohlin, Bruce W. Patterson, Luc J. Zimmermann, Virgilio P. Carnielli, Aaron Hamvas

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective: To determine if high frequency oscillatory ventilation (HFOV) decreases surfactant production in premature infants with respiratory distress syndrome (RDS). Study design: We randomized 19 infants <28 weeks of gestation to either HFOV (n = 8) or conventional ventilation (CV, n = 11) at 24 hours of life. After a 24-hour continuous infusion of uniformly labeled carbon 13 glucose (U∼13C6) glucose, we measured 13C enrichment in surfactant phosphatidylcholine (PC) in tracheal aspirate samples using gas chromatography/mass spectrometry. We calculated the fractional synthetic rate (FSR) of surfactant PC from labeled glucose and its half-life of clearance (T1/2). Results: FSR did not differ between groups (4.7% ± 2.7%/day CV vs 4.2% ± 3.1%/day HFOV, P = .7). T1/2 was 79 ± 18 hours in the CV group and 76 ± 23 hours in the HFOV group (P = .7). Neither degree of ventilatory support nor supplemental oxygen exposure correlated with surfactant metabolic indices. Three of 4 infants who died from RDS within the first month of life had a shorter T1/2 than 14 of 15 infants who survived. Conclusion: Surfactant metabolism is similar in preterm infants ventilated with HFOV and CV. Shortened surfactant half-life may characterize a subset of preterm infants with lethal RDS.

Original languageEnglish
Pages (from-to)693-698
Number of pages6
JournalJournal of Pediatrics
Volume140
Issue number6
DOIs
StatePublished - Jan 1 2002

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