Endothelial cell damage is characteristic for respiratory distress syndrome
and development of chronic lung disease. Vascular endothelial growth facto
r (VEGF) is an endothelial mitogen that takes part in the growth and repair
of vascular endothelial cells. We measured VEGF in 189 tracheal aspirate s
amples (TAF), and in 24 plasma samples from 44 intubated preterm infants (g
estational age, 27.3 +/- 2.0 wk; birth weight, 962 +/- 319 g) during their
first postnatal week. VEGF in TAF increased from 25 +/- 12 pg/ml (mean +/-
SEM) on Day 1 to 526 +/- 120 pg/ml on Day 7 (mean concentrations, 106 +/- 2
5 pg/ml on Days 1 to 3 and 342 +/- 36 pg/ml on Days 4 to 7). In plasma, mea
n concentration of VEGF during the first week was 48 +/- 6 pg/ml, with no i
ncrease observed. In TAF, higher VEGF was found in patients born to mothers
with premature rupture of the membranes, or chorionamnionitis, whereas pre
eclampsia of the mother was associated with lower VEGF (all p < 0.05). In T
AF, no correlations existed between VEGF and gestational age or birth weigh
t, but a correlation existed between lecithin/sphengomyelin ratio and VEGF
(p < 0.05). During Days 4 to 7 patients developing bronchopulmonary dysplas
ia (BPD) had lower VEGF in TAF than did those surviving without BPD (235 +/
- 31 versus 383 +/- 50; p < 0.05). VEGF increased rapidly in the lungs of t
he preterm infant during the first days of life. VEGF may be indicative of
pulmonary maturity and may participate in pulmonary repair after acute lung
injury.