title: Soluble intercellular cell adhesion molecule-1 and L-selectin plasma concentrations and response to surfactant in preterm infants.
abstract: OBJECTIVE
  To investigate whether plasma concentrations of soluble intercellular cell adhesion molecule (ICAM)-1 and L-selectin at 24 hrs of life are related to good or poor response to exogenous surfactant in preterm infants.
  
  
  METHODS
  Prospective study of markers of inflammation in circulating blood at 24 hrs of life.
  
  
  METHODS
  Level III neonatal intensive care unit.
  
  
  METHODS
  Twenty-nine preterm newborns suffering from severe respiratory distress syndrome (Fio(2) > 0.4) without signs of infection or fetal acidosis, and 17 healthy preterm newborns of similar gestational age serving as controls.
  
  
  METHODS
  Infants with respiratory distress were treated with natural surfactant at 0.3-5 hrs of life. A response to surfactant, defined as a decrease of Fio(2) >50% within 6 hrs after surfactant, was seen in 21 infants.
  
  
  RESULTS
  Soluble ICAM-1 and L-selectin concentrations were determined in plasma samples taken at 24 hrs of age. ICAM-1 was elevated (p <.001) in infants who responded poorly to surfactant (median, 392 ng/mL; range, 58.26-4884.24 ng/mL) compared with good responders (20.52 ng/mL, 2.32-138.58 ng/mL) or controls (21.91 ng/mL, 2.61-65.73 ng/mL), without differences between controls and good responders. L-selectin was lower (p =.004) in surfactant-treated infants (4.45 nmol/L, 2.0-10.4 ng/mL) than in controls (6.0/2.35-10.25 nmol/L) without differences between surfactant good and poor responders. However, infants requiring supplemental oxygen at 36 wks of gestational age had reduced L-selectin at 24 hrs of age (3.2/2.0-3.45 vs. 5.0/2.35-10.4 nmol/L, p =.004), whereas there was no difference in ICAM-1.
  
  
  CONCLUSIONS
  In preterm infants with respiratory distress, a poor response to surfactant within 6 hrs of administration is associated with elevated circulating ICAM-1 concentrations at 24 hrs of age. Low plasma L-selectin at 24 hrs of age predicts prolonged requirement for supplemental oxygen.
authors.affiliation: Department of Neonatology, Charité Virchow-Hospital, Humboldt University, Berlin, Germany.
authors.forename: Petra S
authors.initials: PS
authors.lastname: Koehne
authors.forename: Mathias H
authors.initials: MH
authors.lastname: Wagner
authors.forename: Carsten
authors.initials: C
authors.lastname: Willam
authors.forename: Josef
authors.initials: J
authors.lastname: Sonntag
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
authors.forename: Michael
authors.initials: M
authors.lastname: Obladen