title: Prediction of respiratory distress syndrome by the microbubble stability test on gastric aspirates in newborns of less than 32 weeks' gestation.
abstract: OBJECTIVE
  There is a need for a rapid method to identify infants who will develop respiratory distress syndrome (RDS) soon after birth, to allow early treatment of affected infants with surfactant. The microbubble stability test (MST) may be one such method, but clinical experience is sparse.
  
  
  METHODS
  The MST was performed on gastric aspirates from 188 infants with a mean gestational age of 29 (range 23-31) wk.
  
  
  RESULTS
  87 infants developed moderate to severe RDS, corresponding to a prevalence of 46%. The sensitivity, specificity and predictive values for identification of infants with moderate to severe RDS were determined for the average diameter of bubbles, the proportion of microbubbles with different diameters and the total number of microbubbles. The proportion of microbubbles with diameters <20 or 25 microm gave the best prediction, with a sensitivity of 78-79%, a specificity of 57-58%, a positive predictive value of 62% and a negative predictive value of 76%. Early treatment with nasal continuous positive airway pressure probably mitigated the development of RDS in some infants with a low-degree surfactant deficiency and this may explain the relatively low specificity.
  
  
  CONCLUSIONS
  In infants of <32 wk gestation RDS can be predicted by computerized image analysis of the size distribution of microbubbles generated in gastric aspirates.
authors.affiliation: Department of Paediatrics (Neonatology), Holbaek University Hospital, University of Copenhagen, Denmark. chhnve@vestamt.dk
authors.forename: H
authors.initials: H
authors.lastname: Verder
authors.forename: F
authors.initials: F
authors.lastname: Ebbesen
authors.forename: B
authors.initials: B
authors.lastname: Linderholm
authors.forename: B
authors.initials: B
authors.lastname: Robertson
authors.forename: C
authors.initials: C
authors.lastname: Eschen
authors.forename: M
authors.initials: M
authors.lastname: Arrøe
authors.forename: A
authors.initials: A
authors.lastname: Lange
authors.forename: C
authors.initials: C
authors.lastname: Grytter
authors.forename: K
authors.initials: K
authors.lastname: Bohlin
authors.forename: A
authors.initials: A
authors.lastname: Bertelsen
mesh_terms: D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D011175:Positive-Pressure Respiration; D011237:Predictive Value of Tests; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis* / Q000628:therapy
chemical_list: D011663:Pulmonary Surfactants