PLASMA-PROTEINS IN ACUTE AND CHRONIC LUNG-DISEASE OF THE NEWBORN

This study compared plasma levels of albumin, transferrin, and cerulop lasmin in well preterm babies (n = 21) with those with respiratory dis tress syndrome (RDS, n = 13) and chronic lung disease (CLD, n = 13) ov er the first 28 postnatal days. Plasma lipid peroxidation, total radic al trapping capacity (TRAP assay), and iron binding antioxidant capaci ty were also measured. In RDS and CLD albumin levels were decreased on days 1, 4 and 10; on day 10 albumin was lower in CLD compared to RDS (p <.05). After day 10 the levels were similar in all groups. The tran sferrin levels showed a similar trend. Ceruloplasmin levels did not di ffer, except for a higher day 28 level in CLD (p <.05). Albumin levels significantly decreased with increasing FiO(2) and duration of oxygen therapy (within patient r = -0.30, p <.05 and r = -0.51, p <.005, res pectively). On day 10, increasing oxygen therapy increased plasma lipi d peroxidation (r = +0.49, p <.01), which was also significantly relat ed to lower plasma protein levels (r = -0.42, p <.01). Lower plasma al bumin and transferrin lowered the TRAP and iron binding antioxidant ca pacity, respectively (r = +0.36, p <.05, and r = +0.41,p <.005). Predi ction of CLD using day 10 albumin levels had a specificity of 94%, but a sensitivity of only 50%. The interaction between oxygen toxicity an d high ventilation pressures in immature babies appears to lower plasm a proteins by increasing pulmonary permeability. The lower plasma albu min level was not useful in predicting the development of CLD; however , the fall in plasma transferrin and albumin will further decrease the preventive and chain-breaking antioxidant capacity of plasma of these ill babies. (C) 1998 Elsevier Science Inc.