Respiratory distress syndrome in very low birth weigh infants with occasionally normal surfactant phospholipids.

Abstract

Lung effluent phospholipids were analysed in 120 very lwo birth weight (560–1500g) infants within 12 h from birth. The phospholipid profile accurately predicted the presence or absence of respiratory distress syndrome (RDS). However, in three of the 72 RDS cases, the phospholipids revealed no biochemical abnormality as compared to lung effluent from newborns without RDS. In RDS with normal phospholipids, only the lipid-rich fractions of the aspirate were surface active, whereas the protein-rich fraction of the aspirate inhibited the surface activity of lung effluent from normal newborns, suggesting the presence of a surfactant inhibitor. The pathogenesis and treatment of RDS with normal surfactant phospholipids may prove to be different from “classical” RDS.