OBJECTIVES: We hypothesized that inhaled nitric oxide treatment of premature infants at risk for bronchopulmonary dysplasia would not adversely affect endogenous surfactant function or composition. METHODS: As part of the Nitric Oxide Chronic Lung Disease Trial of inhaled nitric oxide, we examined surfactant in a subpopulation of enrolled infants. Tracheal aspirate fluid was collected at specified intervals from 99 infants with birth weights <1250 g who receivedinhaled nitric oxide (20 ppm, weaned to 2 ppm) or placebo gas for 24 days. Large-aggregate surfactant was analyzed for surface activity with a pulsating bubble surfactometer and for surfactant protein contents with an immunoassay. RESULTS: At baseline, before administration of study gas, surfactant function and composition were comparable in the 2 groups, and there was a positive correlation between minimum surface tension and severity of lung disease for all infants. Over the first 4 days of treatment, minimum surface tension increased in placebo-treated infants and decreased in inhaled nitric oxide-treated infants. There were no significant differences between groups in recovery of large-aggregate surfactant or contents of surfactant protein A, surfactant protein B, surfactant protein C, or total protein, normalized to phospholipid. CONCLUSIONS: We conclude that inhaled nitric oxide treatment for premature infants at risk of bronchopulmonary dysplasia does not alter surfactant recovery or protein composition and may improve surfactant function transiently.
RCT Entities:
OBJECTIVES: We hypothesized that inhaled nitric oxide treatment of premature infants at risk for bronchopulmonary dysplasia would not adversely affect endogenous surfactant function or composition. METHODS: As part of the Nitric Oxide Chronic Lung Disease Trial of inhaled nitric oxide, we examined surfactant in a subpopulation of enrolled infants. Tracheal aspirate fluid was collected at specified intervals from 99 infants with birth weights <1250 g who received inhaled nitric oxide (20 ppm, weaned to 2 ppm) or placebo gas for 24 days. Large-aggregate surfactant was analyzed for surface activity with a pulsating bubble surfactometer and for surfactant protein contents with an immunoassay. RESULTS: At baseline, before administration of study gas, surfactant function and composition were comparable in the 2 groups, and there was a positive correlation between minimum surface tension and severity of lung disease for all infants. Over the first 4 days of treatment, minimum surface tension increased in placebo-treated infants and decreased in inhaled nitric oxide-treated infants. There were no significant differences between groups in recovery of large-aggregate surfactant or contents of surfactant protein A, surfactant protein B, surfactant protein C, or total protein, normalized to phospholipid. CONCLUSIONS: We conclude that inhaled nitric oxide treatment for premature infants at risk of bronchopulmonary dysplasia does not alter surfactant recovery or protein composition and may improve surfactant function transiently.
Authors: Michele C Walsh; Anna Maria Hibbs; Camilia R Martin; Avital Cnaan; Roberta L Keller; Eric Vittinghoff; Richard J Martin; William E Truog; Philip L Ballard; Arlene Zadell; Sandra R Wadlinger; Christine E Coburn; Roberta A Ballard Journal: J Pediatr Date: 2010-02-06 Impact factor: 4.406
Authors: Mandy Laube; Elena Amann; Ulrike Uhlig; Yang Yang; Hans W Fuchs; Michael Zemlin; Jean-Christophe Mercier; Rolf F Maier; Helmut D Hummler; Stefan Uhlig; Ulrich H Thome Journal: PLoS One Date: 2017-01-03 Impact factor: 3.240
Authors: Roberta L Keller; Jeffrey D Merrill; Dennis M Black; Robin H Steinhorn; Eric C Eichenwald; David J Durand; Rita M Ryan; William E Truog; Sherry E Courtney; Philip L Ballard; Roberta A Ballard Journal: Pediatr Res Date: 2012-10-04 Impact factor: 3.756