Usefulness of stable microbubble test of tracheal aspirate for the diagnosis of neonatal respiratory distress syndrome

Ny, Boo; Kb, Cheong; Sk, Cheong; Lye, M.; Ma, Zulfiqar

doi:10.1111/j.1440-1754.1997.tb01610.x

Cited by 14 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our data on accuracy of the test to diagnose RDS were very similar to that reported by Boo et al [9] (97.1 vs. 94.6%). In both studies, the performance of the SMT was better than in the study published by Friedrich et al [8] (sensitivity 52%), in which 65 samples were collected from 21 patients with RDS at different moments.…”

Section: Discussionsupporting

confidence: 80%

“…In the study by Boo et al [9] the highest overall accuracy of the SMT for the diagnosis of RDS was 70 SM/ mm 2 . Due to the wide variability of the microbubble count, especially in mature infants, the best cutoff point will probably differ between any two studies, even if performed by the same investigator.…”

Section: Discussionmentioning

confidence: 99%

“…Friedrich et al [8] described low sensitivity for the test (52%) using a cutoff point of 10 stable microbubbles per square millimeter (SM/mm 2 ), and therefore did not encourage its use. On the other hand, Boo et al [9] found a good overall accuracy (94.6%) for a cutoff point of 70 SM/mm 2 . The purpose of this study was to evaluate the accuracy of SMT on tracheal aspirates for the diagnosis of RDS.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Stable Microbubble Test on Tracheal Aspirate for the Diagnosis of Respiratory Distress Syndrome

Seitz

Fiori²,

Luz³

et al. 2005

Neonatology

View full text Add to dashboard Cite

Background: Exogenous surfactant should be used as early as possible in the presence of respiratory distress syndrome (RDS), but diagnosis may only become clear late in the course of the disease. The stable microbubble test (SMT) in the tracheal aspirates could help in the decision to give early surfactant to preterm babies with respiratory distress. Objectives: The objective of this study was to evaluate the accuracy of the SMT on tracheal aspirate for the diagnosis of RDS in newborns requiring mechanical ventilation. Methods: The test was performed on specimens obtained from 74 infants requiring mechanical ventilation, through routine suctioning. Results: Patients with RDS and meconium aspiration syndrome (MAS) had a significantly lower stable microbubble count than non-RDS and non-MAS patients. Preterm infants without RDS had a significantly higher microbubble count than preterm babies with RDS and a similar count to that of term babies. Considering a cutoff point of 120 microbubbles/mm² for the diagnosis of RDS, the sensitivity of the microbubble test was 96.3% (95% CI: 79.1–99.8) and the specificity 97.6% (95% CI: 85.9–99.9). Conclusions: The SMT on tracheal aspirates is accurate for RDS diagnosis and may be useful to support the decision to give surfactant to newborns on mechanical ventilation.

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stable Microbubble Test on Tracheal Aspirate for the Diagnosis of Respiratory Distress Syndrome

Seitz

Fiori²,

Luz³

et al. 2005

Neonatology

View full text Add to dashboard Cite

show abstract

“…Um exemplo disto é o que ocorre em quadros respiratórios de pacientes a termo e próximos ao termo com diagnóstico clínico-radiológico de taquipnéia transitória (TTRN) e síndrome de aspiração de mecônio (SAM). Já foram observados baixos níveis de fosfatidilglicerol no aspirado traqueal 32,33 e no líquido amniótico 34 na TTRN, assim como baixos níveis de proteínas do surfactante na SAM 35 . Desta forma, pode ser difícil saber se uma resposta positiva ao surfactante é devido à reversão da inibição, pela reposição quantitativa na síndrome em questão ou por um quadro de SDR associado, que não pode ser excluído facilmente.…”

Section: Uso De Surfactante No Recém-nascidounclassified

Exogenous surfactant therapy in pediatrics

Freddi¹,

Filho²,

Fiori³

2003

J Pediatr (Rio J)

View full text Add to dashboard Cite

ResumoObjetivo: Revisar o estágio atual do conhecimento sobre a utilização do surfactante exógeno nas diferentes doenças pulmonares que levam à insuficiência respiratória aguda em crianças. Fontes dos dados:Este manuscrito baseia-se na experiência clínica dos autores sobre o assunto e na revisão da literatura recente através de consulta aos bancos de dados ONIA, Mdconsult, Medline e Cochrane Database Library. Síntese dos dados:Apesar do sucesso obtido com a utilização do surfactante exógeno na síndrome de desconforto respiratório do recém-nascido, questões permanecem indefinidas, como o momento do seu emprego, muito precoce (profilático), baseado na idade gestacional ou em testes rápidos de maturidade pulmonar, ou então mais tardiamente, após o quadro clínico instalado. Em outras patologias graves que levam à insuficiência respiratória grave com necessidade de suporte ventilatório, o seu uso ainda é controverso, e os dados da literatura são limitados e conflitantes. Porém, relatos de uso clínico em várias destas situações, com sucesso, têm sido freqüentes. A pesquisa em surfactante tem-se centrado ultimamente na sua inativação por várias substâncias que podem estar presentes na via aérea. Nas patologias em que a inativação parece ser um fator importante, novos surfactantes com adição de adjuvantes para reverter a tendência à inativação (por exemplo: polietilenoglicol) estão atualmente em fase de testes. Conclusões:A terapia com surfactante exógeno ainda não é um tema esgotado, nem mesmo na SDR. Os surfactantes podem ser ainda aperfeiçoados, sobretudo para resistir à inibição, e as formas de utilização em outras doenças que não a SDR deverão ser aperfeiçoadas.J Pediatr (Rio J) 2003;79(Supl.2):S205-S212: Surfactante exógeno, insuficiência respiratória, cuidados intensivos, síndrome de desconforto respiratório. AbstractObjective: To review current knowledge about the use of exogenous surfactants in the treatment of different lung diseases causing acute respiratory failure in children. Source of data:This review is based on the authors' experience and on recent data retrieved from ONIA, Mdconsult, Medline and the Cochrane Database Library. Summary of the findings:In spite of the success of the use of exogenous surfactants in Respiratory Distress Syndrome (RDS) of the newborn, some questions remain unanswered, such as the optimal administration timing -either very early (prophylactic), based on gestational age or on quick tests of lung maturity, or later, when the clinical picture becomes unequivocal. In other severe diseases requiring ventilatory support, the use of surfactants is still controversial, and data in the literature are limited and conflicting. However, successful use in several other diseases has been reported. Recent studies have focused on surfactant inactivation by substances that can be found in the airways. New surfactants with the addition of substances to control inhibition, such as polyethyleneglycol, are being tested for diseases in which inactivation seems to be a significant factor. Conclusio...

show abstract

“…Low levels of phosphatidylglycerol have been found in tracheal aspirates 32,33 and in amniotic fluid 34 in TTN, and low surfactant protein levels in MAS. 35 Therefore, it may be difficult to know whether a positive response to surfactant therapy is due to resolution of inhibition, by quantitative replacement for the syndrome under treatment, or to an associated RDS that cannot be easily ruled out.…”

Section: Use Of Surfactant In the Newbornmentioning

confidence: 99%

Terapia com surfactante pulmonar exógeno em pediatria

Freddi

Filho²,

Fiori³

2003

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To review current knowledge about the use of exogenous surfactants in the treatment of different lung diseases causing acute respiratory failure in children. Sources of data:This review is based on the authors' experience and on recent data retrieved from ONIA, Mdconsult, Medline and the Cochrane Database Library. Summary of the findings:In spite of the success of the use of exogenous surfactants in Respiratory Distress Syndrome (RDS) of the newborn, some questions remain unanswered, such as the optimal administration timing -either very early (prophylactic), based on gestational age or on quick tests of lung maturity, or later, when the clinical picture becomes unequivocal. In other severe diseases requiring ventilatory support, the use of surfactants is still controversial, and data in the literature are limited and conflicting. However, successful use in several other diseases has been reported. Recent studies have focused on surfactant inactivation by substances that can be found in the airways. New surfactants with the addition of substances to control inhibition, such as polyethyleneglycol, are being tested for diseases in which inactivation seems to be a significant factor. Conclusions:Therapy with exogenous surfactants, even as a treatment for RDS, has not been thoroughly investigated. Further studies should be conducted to improve surfactants -mainly their resistance to inhibition -and the treatment of diseases other than RDS.J Pediatr (Rio J) 2003;79 (Suppl 2):S205-S12: Exogenous surfactant, respiratory failure, intensive care, respiratory distress syndrome.

show abstract

Usefulness of stable microbubble test of tracheal aspirate for the diagnosis of neonatal respiratory distress syndrome

Abstract: This study showed that the SM test of tracheal aspirate was a useful bedside diagnostic test for RDS. It could be carried out at any time after birth on infants requiring ventilatory support.

Cited by 14 publications

References 24 publications

Stable Microbubble Test on Tracheal Aspirate for the Diagnosis of Respiratory Distress Syndrome

Stable Microbubble Test on Tracheal Aspirate for the Diagnosis of Respiratory Distress Syndrome

Exogenous surfactant therapy in pediatrics

Terapia com surfactante pulmonar exógeno em pediatria

Contact Info

Product

Resources

About