Preterm infants with high polyunsaturated fatty acid and plasmalogen content in tracheal aspirates develop bronchopulmonary dysplasia less often.
OBJECTIVE
Oxygen toxicity causes chronic bronchopulmonary dysplasia (BPD) in extremely preterm infants. Polyunsaturated fatty acids (PUFA) and plasmalogens are the two main substrates for lipid peroxidation in the pulmonary surfactant. In the present study, we tested whether low concentrations of both were associated with development of BPD and whether both were further reduced during mechanical ventilation with oxygen.


METHODS
Prospective, noninterventional, descriptive study.


METHODS
Level III neonatal intensive care unit in a university hospital.


METHODS
In 25 extremely low birth weight infants with respiratory distress syndrome, tracheal aspirates were collected immediately after birth and in the following 4 days. As control, tracheal and pharyngeal aspirates were collected from healthy infants immediately after birth. The amount of PUFA and dimethylacetals (DMA, representing plasmalogens) was determined gas-chromatographically.


METHODS
None.


RESULTS
The relative percentages of PUFA and DMA on all fatty acids in non-BPD infants (PUFA% 26+/-8.9, DMA% 3.5+/-1.2) were higher compared with infants who developed BPD (PUFA% 14.5+/-3.8, DMA% 1.8+/-0.9). In term healthy infants, DMA% and PUFA% were in the same range as in the BPD group. The higher levels found for non-BPD infants decreased after day 1 to values equal to the BPD group and remained low.


CONCLUSIONS
The results suggest that initially higher levels of PUFA and plasmalogens in the tracheal effluent are associated with a reduced risk of developing BPD and are reduced during the first day of ventilation.
Rüdiger
M
M
Department of Neonatology, Charité, Hospital of Humboldt University, Berlin, Germany.
von Baehr
A
A
Haupt
R
R
Wauer
R R
RR
Rüstow
B
B
D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis* / Q000378:metabolism; D005231:Fatty Acids, Unsaturated / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015227:Lipid Peroxidation / Q000502:physiology; D008297:Male; D010955:Plasmalogens / Q000378:metabolism*; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000378:metabolism; D012307:Risk Factors; D014132:Trachea / Q000378:metabolism*
D005231:Fatty Acids, Unsaturated; D010955:Plasmalogens; D011663:Pulmonary Surfactants