Evaluation of surfactant function at birth determined by the stable microbubble test in term and near term infants with respiratory distress

Fiori, Humberto Holmer; Henn, Roseli; Baldisserotto, Matteo; Bica, Igor; Fiori, Renato Machado

doi:10.1007/s00431-004-1473-2

Cited by 21 publications

(12 citation statements)

References 17 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All the staff of the unit is trained in the technique as SMT has been routinely used for many years. The good inter-and intra-observer agreement in the SMT performed in gastric aspirates has already been reported [19] .…”

Section: Methodsmentioning

confidence: 82%

Lamellar Body Count and Stable Microbubble Test on Gastric Aspirates from Preterm Infants for the Diagnosis of Respiratory Distress Syndrome

et al. 2010

View full text Add to dashboard Cite

Background: Lamellar body count (LBC) in amniotic fluid is being used to identify infants at risk of respiratory distress syndrome (RDS) who would benefit from surfactant prophylaxis or very early therapy. The test in gastric aspirates of newborns has not been properly explored. Objective: The main objective of this research was to evaluate the performance of LBC alone or in combination with the stable microbubble test (SMT), done on gastric aspirates from preterm babies to predict RDS. Methods: A total of 34 preterm infants with RDS and 29 without RDS, with a gestational age between 24 and 34 weeks, were included in the study. Gastric fluid was collected in the delivery room. A diluent (dithiothreitol) allowed all samples to be processed, even the thickest and non-homogeneous ones, without centrifugation. The SMT was done for comparison. Results: The best cut-off value was <42,000 lamellar bodies/µl to predict RDS, with a sensitivity of 92% (95% CI 73–100%) and specificity of 86% (95% CI 77–95%). The area under the receiver-operating characteristic curve was 0.928 (95% CI 0.86–0.99). SMT showed similar results. LBC and SMT together in series (positive result if both tests were positive) showed a sensitivity of 100% and a specificity of 86%. Conclusion: LBC on gastric aspirates diluted in a solution of dithiothreitol can be rapidly and easily performed, and may be used alone or in combination with SMT as a predictor of RDS, allowing selective prophylaxis or very early treatment only in surfactant-deficient newborns.

show abstract

Section: Methodsmentioning

confidence: 82%

Lamellar Body Count and Stable Microbubble Test on Gastric Aspirates from Preterm Infants for the Diagnosis of Respiratory Distress Syndrome

et al. 2010

View full text Add to dashboard Cite

show abstract

“…We found some intra-observer variability which may be due to the sample being frozen for a month and then re-analysed. However, the effect of freezing on gastric aspirates has been tested by Fiori et al [20] and found not to significantly influence results. We did not assess inter-observer variability.…”

Section: Discussionmentioning

confidence: 99%

“…We did not assess inter-observer variability. Fiori et al [20] found a κ coefficient of 0.88 for counts by different observers at a higher count of 35 microbubbles/mm 2 indicating good intra-observer variability.…”

Section: Discussionmentioning

confidence: 99%

The Stable Microbubble Test for Determining Continuous Positive Airway Pressure (CPAP) Success in Very Preterm Infants Receiving Nasal CPAP from Birth

et al. 2013

View full text Add to dashboard Cite

Background: Very preterm infants can be treated with nasal continuous positive airway pressure (CPAP) from birth, but some fail. A rapid test, such as the stable microbubble test (SMT) on gastric aspirate, may identify those who can be managed successfully using CPAP. Objective: To determine if SMT can identify soon after birth, very preterm infants who may be successfully managed on CPAP alone. Methods: Stable microbubbles (diameter <15 µm) were counted in gastric aspirates taken <1 h of age from infants <30 weeks' gestation, who received CPAP from birth. Infants failed CPAP if intubated at <72 h of age. Clinicians were masked to SMT results. A receiver operating characteristic curve was generated to determine the relationship between number of microbubbles/mm² and subsequent intubation. Results: 68 infants of mean (SD) 28.1 (1.4) weeks' gestation received CPAP in the delivery room at a median (interquartile range) pressure 7 (6-8) cmH₂O and FiO₂ 0.25 (0.21-0.3). Gastric aspirates were taken at a median (interquartile range) age of 0.5 (0.3-0.6) hours. The best cut-off point for predicting CPAP success or failure was a SMT count of 8 microbubbles/mm². The area under the receiver operating characteristic curve was 0.8 (95% CI 0.7-0.9). A SMT count ≥8 microbubbles/mm² had a sensitivity of 53%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 60% for predicting CPAP success. Conclusion: Infants treated with CPAP from birth, who hadSMT counts ≥8 microbubbles/mm² on their gastric aspirate, did not fail CPAP.

show abstract

“…However, amniotic fluid collection at birth is difficult. As an index of the maturity of the fetal lung at birth, the microbubble test is commonly employed in Japan 3 . While some studies have investigated the SP‐A concentration in gastric fluid instead of amniotic fluid at birth, 4–7 there is no publication written in English, and cut‐off values vary due to limited data.…”

Section: There Were Significant Differences In the Birthweight And Gementioning

confidence: 99%

“…As an index of the maturity of the fetal lung at birth, the microbubble test is commonly employed in Japan. 3 While some studies have investigated the SP-A concentration in gastric fluid instead of amniotic fluid at birth, [4][5][6][7] there is no publication written in English, and cut-off values vary due to limited data. In this study, we performed a large-scale, retrospective analysis to examine the association between the gastric fluid concentration of SP-A and clinical symptoms in 179 neonates born in our hospital.…”

mentioning

confidence: 99%

Surfactant protein A in gastric fluid at birth as a useful marker of differentiation diagnosis between respiratory distress syndrome and transient tachypnea of the newborn

Matsuzaki

Hokuto

Ikeda

2011

Pediatrics International

View full text Add to dashboard Cite

Evaluation of surfactant function at birth determined by the stable microbubble test in term and near term infants with respiratory distress

Cited by 21 publications

References 17 publications

Lamellar Body Count and Stable Microbubble Test on Gastric Aspirates from Preterm Infants for the Diagnosis of Respiratory Distress Syndrome

Lamellar Body Count and Stable Microbubble Test on Gastric Aspirates from Preterm Infants for the Diagnosis of Respiratory Distress Syndrome

The Stable Microbubble Test for Determining Continuous Positive Airway Pressure (CPAP) Success in Very Preterm Infants Receiving Nasal CPAP from Birth

Surfactant protein A in gastric fluid at birth as a useful marker of differentiation diagnosis between respiratory distress syndrome and transient tachypnea of the newborn

Contact Info

Product

Resources

About