Calcium, potassium, urea and total protein are not reliable dilutional markers of bronchoalveolar small volume-lavages in ventilated preterm human neonates.
In order to better understand the lung pathology in neonates, more information on basic parameters and their usefulness as dilutional markers in epithelial lining fluid (ELF) is desirable. In this study we determined the amounts of calcium (Ca++), potassium (K+), total protein, albumin and urea in specimens, obtained by small volume lavage, and also in serum from premature infants, who have and have not had surfactant treatment. None of the serum/lavage ratios of these parameters generally increased the correlation between the serum and lavage values of the other parameters and all were thus unreliable markers for the calculation of the dilution of lung ELF as recovered by the small volume lavage procedure. However, the consistently different magnitudes of these ratios appeared to allow gross estimates of the relative concentrations of these parameters between one another. On the basis of a serum/lavage ratio for urea of 1, K+ and Ca++ were concentrated in ELF by a factor of 2 in relation to serum, whereas the protein concentration was 2-3 times lower than in serum. Generally it appears most appropriate to express the results obtained in analyses of lavages either as the uncorrected concentrations per ml recovered lavage fluid or as the ratio of two parameters simultaneously determined in the lavage. In this study, except for marginally increased Ca++ concentrations during the first days of life in surfactant treated neonates, no differences were noted for K+, urea or protein between neonates treated with surfactant or without.
Griese
M
M
Kinderpoliklinik, Ludwig-Maximilians University, Munich, Germany.
Potz
C
C
Dietrich
P
P
Westerburg
B
B
D015415:Biomarkers; D001798:Blood Proteins / Q000032:analysis; D018893:Bronchoalveolar Lavage / Q000379:methods; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D002118:Calcium / Q000032:analysis* / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood / Q000502:physiology*; D011188:Potassium / Q000032:analysis* / Q000097:blood; D011506:Proteins / Q000032:analysis*; D011663:Pulmonary Surfactants / Q000032:analysis; D014508:Urea / Q000032:analysis* / Q000097:blood
D015415:Biomarkers; D001798:Blood Proteins; D011506:Proteins; D011663:Pulmonary Surfactants; D014508:Urea; D011188:Potassium; D002118:Calcium