Bronchoalveolar Lavage Surfactant Protein A, B, and D Concentrations in Preterm Infants Ventilated for Respiratory Distress Syndrome Receiving Natural and Synthetic Surfactants

摘要

Surfactant proteins (SPs) play an important role in surfactant metabolism and function. Understanding their relative contribution to clinical outcome remains incomplete. Exogenous surfactants differ in their SP content and physiologic effects. The aims of this study were to measure bronchoalveolar lavage (BAL) SP concentrations from preterm infants ventilated for respiratory distress syndrome and to assess their association with clinical outcome. Fifty preterm infants randomized to receive a natural or synthetic surfactant were lavaged each day for the first week and twice weekly thereafter using a standardized nonbronchoscopic technique. BAL SP-A, SP-B, and SP-D concentrations were measured using ELISA. Median BAL SP-A, SP-B, and SP-D concentrations for the whole cohort rose significantly during the first postnatal week (p Abbreviations: BAL, bronchoalveolar lavage; CLD, chronic lung disease of prematurity; IUGR, intrauterine growth retardation; IVH, intraventricular hemorrhage; IQR, interquartile range; NB-BAL, nonbronchoscopic BAL; RDS, respiratory distress syndrome; SP, surfactant protein