Abstract

Objective: to study the production of surfactant apoprotein D in preterm neonates with acute respiratory distress syndrome (ARDS) during artificial ventilation (AV). Subjects and methods. The paper presents the results of studying the production of surfactant protein D (SP-D) in various biological fluids in 44 preterm neonates. Two groups of newborn infants were identified according to the clinical manifestations of ARDS. The study group comprised 25 infants with the severe course of the disease, in this connection the preventive administration of the exogenous surfactant Curosurf and AV were made in all the neonates at birth. The control group included 19 preterm babies without signs of ARDS. Results. The study has demonstrated that in parturients and preterm neonatal infants, surfactant apoprotein D is detectable in various biological fluids: amniotic fluid, the gastric aspirate obtained just after birth, residual umbilical cord blood, serum following 8 hours of birth, and bronchoalveolar fluid. Despite the low gestational age of the neonates, the lung surfactant system is able to produce SP-D, as evidenced by its high content in the amniotic fluid and residual umbilical cord blood of preterm neonates. The production of apoprotein D in preterm neonates considerably reduces in the next few hours after birth. Conclusion. The findings suggest that fetal tissues generate SP-D, which improves pulmonary gas exchange in preterm neonates in the first hours after birth and that alveolar-capillary membrane dysfunctions are transient in the neonates on AV. Key words: preterm neonates, acute respiratory distress syndrome, surfactant, surfactant apoprotein D.

Highlights

  • Objective: to study the production of surfactant apoprotein D in preterm neonates with acute respiratory distress syndrome (ARDS) during artificial ventilation (AV)

  • The paper presents the results of study ing the production of surfactant protein D (SP D) in various biological fluids in 44 preterm neonates

  • The study group comprised 25 infants with the severe course of the disease, in this connection the preventive administration of the exogenous sur factant Curosurf and AV were made in all the neonates at birth

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Summary

CУРФАКТАНТНЫЙ АПОПРОТЕИН D У НЕДОНОШЕННЫХ НОВОРОЖДЁННЫХ С ОРДС

Цель работы — исследование продукции сурфактантного апопротеина D у недоношенных новорождённых с ОРДС во время проведения ИВЛ. Полученные результаты свидетельствуют о внутриутробной продукции SP D тканями плода, способствующей улучшению газообменной функции лёгких у недоношенных но ворождённых в первые часы после рождения, о наличии транзиторных нарушений функции альвеоло капилляр ной мембраны у новорождённых, находящихся на ИВЛ. Objective: to study the production of surfactant apoprotein D in preterm neonates with acute respiratory distress syndrome (ARDS) during artificial ventilation (AV). Искусственная вентиляция лёгких, являющаяся ос новным методом лечения ОРДС у недоношенных новорож дённых, может вызывать повреждение альвеолярного эпи телия, угнетении синтеза эндогенного сурфактанта и его повышенную деградацию, что способствует вторичному де фициту сурфактанта и ухудшает течение заболевания.

Материалы и методы
Длительность ИВЛ
Результаты и обсуждение
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