Data for a Rapid Lung Maturity Test Published in ACTA Paediatrica
Recently Published European Consensus Guidelines Highlight the Need for a Bedside Test
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.
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.
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.
Our rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted RDS with high sensitivity.