Role of digoxin-like immunoreactive substance in the pathogenesis of transient tachypnea of newborn.
BACKGROUND
Transient tachypnea of newborn (TTN) is usually observed in term or near-term infants. It constitutes an important part of the respiratory distress cases observed in the neonatal intensive care unit (NICU).


OBJECTIVE
This paper examines the effects of digoxin-like immunoreactive substance (DLIS) on fluid and ion balance, hemodynamic and echocardiographic parameters of neonates with TTN.


METHODS
Plasma DLIS, Na(+), K(+), urea, creatinine, serum and urine osmolarity, urine FeNa(+), 24-hour urine output, echocardiographic investigation and mean blood pressure, and clinical parameters of disease severity were recorded in TTN group and compared with control on the 1st and 7th days of their lives.


RESULTS
Plasma DLIS levels were statistically higher in TTN group (0.66 ± 0.37 ng/mL) compared to control group (0.24 ± 0.20 ng/mL) both on the 1st day (P < 0.01) and the 7th day (P < 0.05). For TTN group, significant correlation was found between plasma DLIS levels and maximum respiratory rate, duration of tachypnea, and length of hospitalization on the 1st day. Plasma DLIS levels were correlated negatively with serum osmolarity levels. Plasma DLIS levels were positively correlated with urine output, urinary FeNa(+) levels, cardiac output, left ventricles end diastolic diameters, and right ventricles end diastolic diameters.


CONCLUSIONS
Increased DLIS levels were correlated with disease severity in cases with TTN. This increase may be a primary or secondary event in the disease progress. It may help reduce the fluid overload due to already disturbed cardiac functions in patients by increasing urine output and natriuresis; however it may also contribute to disease pathogenesis, by inhibiting alveolar Na(+)-K(+)-ATPase which further decreases fetal alveolar fluid resorption.
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey. mehmet.yalaz@ege.edu.tr
Mehmet
M
Yalaz
Erturk
E
Levent
Murat
M
Olukman
Sebnem
S
Calkavur
Mete
M
Akisu
Nilgun
N
Kultursay
D002298:Cardenolides / Q000097:blood*; D004452:Echocardiography; D005260:Female; D005290:Ferric Compounds / Q000652:urine; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009571:Nitrilotriacetic Acid / Q000031:analogs & derivatives / Q000652:urine; D009994:Osmolar Concentration; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood* / Q000473:pathology; D012503:Saponins / Q000097:blood*; D000254:Sodium-Potassium-Exchanging ATPase / Q000378:metabolism; D047929:Term Birth / Q000097:blood*; D059245:Transient Tachypnea of the Newborn / Q000097:blood* / Q000473:pathology; D014882:Water-Electrolyte Balance
D002298:Cardenolides; D005290:Ferric Compounds; D012503:Saponins; C034504:digoxin-like factors; D000254:Sodium-Potassium-Exchanging ATPase; D009571:Nitrilotriacetic Acid; C020326:ferric nitrilotriacetate