DIFFERENTIAL LEUKOCYTE COUNT IN BABIES TREATED WITH NATURAL SURFACTANT

The potential of exogenous replacement therapy in su surfactant-defici ent states such as neonatal respiratory distress syndrome (RDS) is an area of intense clinical interest today. At present, a fundamental pro blem with any type of exogenous surfactant is the uncertainty about po tential effects on physiological defense mechanisms, such as different iation and mobilization of peripheral leukocytes. Considering that new born infants with proven bacterial infections have abnormal values of segmented (neutrophil) and nonsegmented (band) polymorphonuclear leuko cytes, we studied 42 placebo- versus Curosurf-treated babies with seve re RDS. Differential white blood cell (WBC) count was serially perform ed before and after treatment during the first days of lifer The stati stically significant increase in the proportion of bands in surfactant -treated babies did not coincide with clinical and bacteriologic evide nce of possible infection. Some molecular interaction mechanisms influ encing immature to mature WBC ratio are supposed. Among a variety of i nfluences on the leukocyte count, surfactant replacement therapy needs to be considered for proper interpretation of hematologic data in bab ies treated for RDS.