Preterm infants with high polyunsaturated fatty acid and plasmalogen content in tracheal aspirates develop bronchopulmonary dysplasia less often

Objective: Oxygen toxicity causes chronic bronchopulmonary dysplasia (BPD) in extremely preterm infants, Polyunsaturated fatty acids (PUFA) and plasma logens are the two main substrates for lipid peroxidation in the pulmonary surfactant. In the present study, we tested whether low concentrations of b oth were associated with development of BPD and whether both were further r educed during mechanical ventilation with oxygen. Design: Prospective, noninterventional, descriptive study. Setting: Level III neonatal intensive care unit in a university hospital. Patients: In 25 extremely low birth weight infants with respiratory distres s syndrome, tracheal aspirates were collected immediately after birth and i n the following 4 days. As control, tracheal and pharyngeal aspirates were collected from healthy infants immediately after birth. The amount of PUFA and dimethylacetals (DMA, representing plasmalogens) was determined gas-chr omatographically. Interventions: None. Measurements and Main Results: The relative percentages of PUFA and DMA on all fatty acids in non-BPD infants (PUFA% 26 +/- 8.9, DMA% 3.5 +/- 1.2) wer e higher compared with infants who developed BPD (PUFA% 14.5 +/- 3.8, DMA% 1.8 +/- 0.9). In term healthy infants, DMA% and PUFA% were in the same rang e as in the BPD group. The higher levels found for non-BPD infants decrease d after day 1 to values equal to the BPD group and remained low. Conclusions: The results suggest that initially higher levels of PUFA and p lasmalogens in the tracheal effluent are associated with a reduced risk of developing BPD and are reduced during the first day of ventilation.