Premature infants with lung disease may continue to need replacement substance to ease breathing
Physicians have known for decades that many premature babies suffer respiratory problems stemming from insufficiency of a lung substance called surfactant during their first few weeks of life. The standard treatment has been to provide replacement surfactant immediately after birth. A new study has found that even after infants begin producing their own surfactant, it often fails to function properly in premature infants who continue to have lung disease after their first week.
The study also raises the question of whether additional replacement surfactant treatment may benefit such infants, just as it does in the week after birth.
Neonatology researchers from The Childrens Hospital of Philadelphia and the University of Pennsylvania published the study in the October 20 online edition of the journal Pediatric Research. It was the first study of surfactant dysfunction in infants beyond the first week of life. "We studied premature babies who require mechanical ventilation to breathe after one week of age," said Philip L. Ballard, M.D., Ph.D., director of Neonatology Research at The Childrens Hospital of Philadelphia. "We found that three-quarters of these high-risk infants have episodes of surfactant dysfunction, and these episodes are associated with worsening of their respiratory status."
Surfactant is a naturally produced mixture of proteins and lipids (fats) that lowers surface tension within alveoli, the tiny air sacs within the lungs. By doing so, it prevents the alveoli from collapsing during exhalation, and eases the work of breathing. Premature infants have underdeveloped respiratory systems and do not produce enough of their own surfactant. Therefore, physicians have found that supplying replacement surfactant may improve infants lung function during the earliest period after birth.
Replacement surfactant is discontinued after babies begin to produce enough surfactant on their own. However, infants with persistent lung disease may develop a condition called bronchopulmonary dysplasia (BPD), in which chronic respiratory distress makes it necessary for infants to breathe through a mechanical ventilator. BPD can cause long-term disability or death.
In this study, the researchers analyzed samples of fluid from the windpipes of 68 premature infants who had breathing tubes between one to 12 weeks after birth. Seventy-five percent of the infants on at least one occasion had abnormal surfactant function, and diminished amounts of an important component of surfactant, called surfactant protein B. In addition, these surfactant abnormalities were significantly more likely to occur during periods of respiratory infection and worsened respiratory status.
Babies are defined as premature if they are born before 37 weeks of gestation. Most premature babies have symptoms of respiratory distress, with the risk increasing with greater prematurity. The infants in this study were very premature, having been born at 23 to 30 weeks gestation. "Premature infants with continuing respiratory failure and abnormal surfactant may benefit from treatment with replacement surfactant--or from strategies to increase their own production of surfactant," said Dr. Ballard, who has been studying infant lung development for more than 30 years. He and his colleagues are currently carrying out a pilot trial of surfactant therapy in preterm infants older than 7 days, and they are planning a clinical trial to investigate short- and long-term safety and effectiveness of surfactant treatment in these infants.
John Ascenzi | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...