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

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

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.

Gastric aspirate, Lung surfactant, Mid-infrared spectroscopy, Prematurity, Respiratory distress syndrome
0803-5253
430-437
Verder, Henrik
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Heiring, Christian
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Clark, Howard
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Sweet, David
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Jessen, Torben E.
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Ebbesen, Finn
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Björklund, Lars J.
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Andreasson, Bengt
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Bender, Lars
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Bertelsen, Aksel
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Dahl, Marianne
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Eschen, Christian
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Fenger-Grøn, Jesper
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Hoffmann, Stine F.
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Höskuldsson, Agnar
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Bruusgaard-Mouritsen, Maria
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Lundberg, Fredrik
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Postle, Anthony D.
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Schousboe, Peter
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Schmidt, Peter
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Stanchev, Hristo
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Sørensen, Lars
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Verder, Henrik
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Heiring, Christian
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Clark, Howard
70550b6d-3bd7-47c6-8c02-4f43f37d5213
Sweet, David
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Jessen, Torben E.
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Ebbesen, Finn
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Björklund, Lars J.
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Andreasson, Bengt
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Bender, Lars
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Bertelsen, Aksel
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Dahl, Marianne
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Eschen, Christian
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Fenger-Grøn, Jesper
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Hoffmann, Stine F.
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Höskuldsson, Agnar
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Bruusgaard-Mouritsen, Maria
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Lundberg, Fredrik
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Postle, Anthony D.
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Schousboe, Peter
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Schmidt, Peter
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Stanchev, Hristo
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Sørensen, Lars
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Verder, Henrik, Heiring, Christian, Clark, Howard, Sweet, David, Jessen, Torben E., Ebbesen, Finn, Björklund, Lars J., Andreasson, Bengt, Bender, Lars, Bertelsen, Aksel, Dahl, Marianne, Eschen, Christian, Fenger-Grøn, Jesper, Hoffmann, Stine F., Höskuldsson, Agnar, Bruusgaard-Mouritsen, Maria, Lundberg, Fredrik, Postle, Anthony D., Schousboe, Peter, Schmidt, Peter, Stanchev, Hristo and Sørensen, Lars (2017) Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity. Acta Paediatrica, 106 (3), 430-437. (doi:10.1111/apa.13683).

Record type: Article

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.

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Verder_et_al-2017-Acta_Paediatrica - Version of Record
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Accepted/In Press date: 22 November 2016
e-pub ahead of print date: 20 December 2016
Published date: 1 March 2017
Keywords: Gastric aspirate, Lung surfactant, Mid-infrared spectroscopy, Prematurity, Respiratory distress syndrome

Identifiers

Local EPrints ID: 418627
URI: https://eprints.soton.ac.uk/id/eprint/418627
ISSN: 0803-5253
PURE UUID: 0b5df1e1-69cb-4210-b314-7afd1663822e
ORCID for Anthony D. Postle: ORCID iD orcid.org/0000-0001-7361-0756

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Date deposited: 13 Mar 2018 17:30
Last modified: 10 Dec 2019 01:59

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Contributors

Author: Henrik Verder
Author: Christian Heiring
Author: Howard Clark
Author: David Sweet
Author: Torben E. Jessen
Author: Finn Ebbesen
Author: Lars J. Björklund
Author: Bengt Andreasson
Author: Lars Bender
Author: Aksel Bertelsen
Author: Marianne Dahl
Author: Christian Eschen
Author: Jesper Fenger-Grøn
Author: Stine F. Hoffmann
Author: Agnar Höskuldsson
Author: Maria Bruusgaard-Mouritsen
Author: Fredrik Lundberg
Author: Peter Schousboe
Author: Peter Schmidt
Author: Hristo Stanchev
Author: Lars Sørensen

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