title: Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity.
abstract: OBJECTIVE
  Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear, it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation.
  
  
  METHODS
  Concentrations of the most surface-active lung phospholipid dipalmitoylphosphatidylcholine and sphingomyelin in gastric aspirates from premature infants were measured by mass spectrometry and expressed as the lecithin/sphingomyelin ratio (L/S). The same aspirates were analysed with mid-infrared spectroscopy. Subsequently, L/S was measured in gastric aspirates and oropharyngeal secretions from another group of premature infants using spectroscopy and the results were compared with RDS development. The 10-minute analysis required 10 μL of aspirate.
  
  
  RESULTS
  An L/S algorithm was developed based on 89 aspirates. Subsequently, gastric aspirates were sampled in 136 infants of 24-31 weeks of gestation and 61 (45%) developed RDS. The cut-off value of L/S was 2.2, sensitivity was 92%, and specificity was 73%. In 59 cases, the oropharyngeal secretions had less valid L/S than gastric aspirate results.
  
  
  CONCLUSIONS
  Our rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted RDS with high sensitivity.
authors.affiliation: Departments of Pediatrics, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Verder
authors.affiliation: Department of Neonatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Heiring
authors.affiliation: Department of Neonatology, Southampton Hospital, University of Southampton, England, UK.
authors.forename: Howard
authors.initials: H
authors.lastname: Clark
authors.affiliation: Department of Neonatology, Royal Maternity Hospital, Belfast, Northern Ireland, UK.
authors.forename: David
authors.initials: D
authors.lastname: Sweet
authors.affiliation: Department of Clinical Biochemistry, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Torben E
authors.initials: TE
authors.lastname: Jessen
authors.affiliation: Department of Pediatrics Aalborg Hospital, University of Aalborg, Aalborg, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Ebbesen
authors.affiliation: Departments of Pediatric Surgery and Neonatology, Skåne University Hospital, Lund, Sweden.|Department of Clinical Sciences, University of Lund, Lund, Sweden.
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Björklund
authors.affiliation: Departments of Pediatric Surgery and Neonatology, Skåne University Hospital, Lund, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Andreasson
authors.affiliation: Department of Pediatrics Aalborg Hospital, University of Aalborg, Aalborg, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Bender
authors.affiliation: Departments of Pediatrics, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Aksel
authors.initials: A
authors.lastname: Bertelsen
authors.affiliation: Department of Pediatrics, Odense Hospital, University of Southern, Odense, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Dahl
authors.affiliation: Departments of Pediatrics, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Eschen
authors.affiliation: Department of Pediatrics, Kolding Hospital, University of Southern, Koldin, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Fenger-Grøn
authors.affiliation: Departments of Pediatrics, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Stine F
authors.initials: SF
authors.lastname: Hoffmann
authors.affiliation: Departments of Pediatrics, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Agnar
authors.initials: A
authors.lastname: Höskuldsson
authors.affiliation: Departments of Pediatrics, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Maria
authors.initials: M
authors.lastname: Bruusgaard-Mouritsen
authors.affiliation: Department of Neonatology Linköping, University of Linköping, Linköping, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Lundberg
authors.affiliation: Child Health, Academic Unit of Clinical and Experimental Sciences and Respiratory Biomedical Research Unit, Southampton General Hospital, University of Southampton, England, UK.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Postle
authors.affiliation: Departments of Pediatrics, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Schousboe
authors.affiliation: Department of Pediatrics, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Schmidt
authors.affiliation: Department of Pediatrics, Naestved University Hospital, Naestved, Denmark.
authors.forename: Hristo
authors.initials: H
authors.lastname: Stanchev
authors.affiliation: Departments of Pediatrics, Holbaek University Hospital, Holbaek, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Sørensen
mesh_terms: D012634:Bodily Secretions / Q000737:chemistry; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000254:growth & development*; D008297:Male; D010713:Phosphatidylcholines / Q000032:analysis* / Q000378:metabolism; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis*; D013109:Sphingomyelins / Q000032:analysis* / Q000378:metabolism
chemical_list: D010713:Phosphatidylcholines; D013109:Sphingomyelins
keywords: Gastric aspirate; Lung surfactant; Mid-infrared spectroscopy; Prematurity; Respiratory distress syndrome