Serial lecithin/sphingomyelin ratios and surfactant/albumin ratios in tracheal aspirates from term infants with respiratory failure receiving extracorporeal membrane oxygenation

• Published in: Clinical chemistry (Baltimore, Md.) Vol. 41; no. 8; pp. 1182 - 1188
• Main Authors: Lotze, A, Stroud, CY, Soldin, SJ
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Assoc Clin Chem 01.08.1995; American Association for Clinical Chemistry
• Subjects: Albumins - analysis; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Chromatography, High Pressure Liquid; Double-Blind Method; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Extracorporeal Membrane Oxygenation; Humans; Infant, Newborn; Intensive care medicine; Lung Compliance; Medical sciences; Phosphatidylcholines - analysis; Prospective Studies; Pulmonary Surfactants - analysis; Respiratory Insufficiency - metabolism; Sphingomyelins - analysis; Trachea - metabolism; Human; Lung disease; Lecithin; Respiratory disease; Lipids; Exploration; Hyaline membrane; Tracheobronchial secretion; Newborn diseases; Newborn; Respiratory failure; Sphingomyelin; Respiratory distress; Quantitative analysis
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1093/clinchem/41.8.1182

Serial tracheal aspirate samples were obtained for determination of lecithin/sphingomyelin (L/S) ratios from 47 term infants in respiratory failure. Phospholipids were extracted with Folch solution (chloroform:methanol, 2:1 by vol) and analyzed by HPLC with use of silica column and a mobile phase of acetonitrile:methanol:water (48:31:21, by vol). Surfactant/albumin (S/A) ratios were determined with the TDx Fetal Lung Maturity Assay (Abbott Labs). L/S ratios increased significantly over time in all patients (F = 19.42, P < 0.0001). The S/A ratio correlated with the L/S ratio (r = 0.554, P < 0.001). This study suggests that postnatal surfactant deficiency in term newborns with respiratory failure is a component of the newborn's lung injury.