MICROBUBBLE STABILITY TEST ON GASTRIC ASPIRATE FOR RAPID DIAGNOSIS
OF RESPIRATORY DISTRESS SYNDROME IN BABIES LESS THAN 32 WEEKS GESTATION
Verder H1, Ebbesen F2,
Robertson B3, Linderholm B3, Berggren P3,
Eschen C1, Arrøe M4, Greisen G4, Lange A5,
GrytterC6, Blennow M7, Kroner J8, Vrang C9,
Olofsson K10, Christensen MF11, Petersen MB12, Nielsen LH13, Albertsen
P14
3Department of Surgical Sciences Karolinska
Hospital, Sweden and Departments of Pediatrics/Neonatology 11Herning,
14Hilleroed, 1Holbaek, 10Hvidovre, 6Kolding,
9Naestved, 8Odense, 12Roskilde, 4Rigshospitalet
Copenhagen, 13Soenderborg, 2Aalborg, 5Aarhus,
Denmark and 7Department of Pediatrics/Neonatology Huddinge,
Stockholm, Sweden
Objective: It has previously been
suggested that the microbubble stability test (MST) could be a useful tool
for rapid diagnosis of surfactant deficiency [Berggren et al.: Biol Neonate 1999;76
(supp11):44 et Fiori & Fiori: Biol Neonate 2000;77 (suppl 1):26 ]. However, only a few babies less than 32
weeks´ of gestation have been examined.
Methods: Gastric aspirates were obtained
less than 2 h after birth from 112 babies with gestational age 28 (23-31)
wk´s and birth weight 1263 (475-2194) g. The aspirates were centrifuged at
500 g for 2 min and afterwards
frozen at 20¡ãC until examination. The samples
were vortexed and examined for microbubbles as previously described [Berggren et al.: Biol Neonate 1997;71(suppl
1):64]. The diagnosis of respiratory
distress syndrome (RDS) was made clinically [Verder et al.: Pediatrics 1999;103:E24] and radiologically. Microbubbles were
defined as bubbles with a diameter <20 mm. Good surfactant activity was defined as
>66% microbubbles.
Results:
Fifty-eight babies (51%)
developed moderate to severe RDS. MST identified these babies with a sensitivity
of 75% and a specificity 73%.
Conclusion: Evaluation of MST on gastric aspirate seems to be useful for the
diagnosis of RDS. We are planning a clinical trial using MST for rapid
detection of babies requiring of surfactant replacement.