Platelet-activating factor in surfactant preparations.

Surfactant administration is used for treatment of neonatal respiratory distress syndrome. We studied whether currently used surfactant preparations contain platelet-activating factor (PAF), a potent lipid mediator produced by fetal lungs. Three surfactant preparations from animal sources contained between 36 and 218 pmol of PAF per mL, whereas PAF was undetectable in an artificial surfactant. Based on current recommendations, about 144-654 pmol PAF would be administered per dose of natural surfactant, sufficient to exert possible physiological effects on the lung. The action of PAF may be exacerbated by low activity of PAF-acetylhydrolase, which inactivates PAF, in tracheal fluid from infants with respiratory distress syndrome.