LYSOPHOSPHATIDYLCHOLINE AND OUTCOME OF PRETERM BABIES WITH RESPIRATORY-DISTRESS SYNDROME TREATED WITH SURFACTANT

Phosphatidylcholine (PC) is the predominant phospholipid in natural su rfactant preparations. A metabolic intermediate, lyso-PC, is potential ly injurious to the lungs. In the present study, tracheal aspirates fr om preterm babies with respiratory distress syndrome treated with surf actant were examined for the presence of lyso-PC to determine if there was any correlation with outcome. Eighteen babies were assigned to re ceive initially either 100 or 200 mg/kg Curosurf followed by up to thr ee further 100-mg/kg doses if required. Lyso-PC was present in aspirat es taken 12-24 h after the last treatment from nine of 11 infants who initially received 200 mg/kg but in only one from seven receiving 100 mg/kg initially, and was dependent on the total dose of phospholipid a dministered. Three babies in the low-dose group developed bronchopulmo nary dysplasia, whereas two in the high-dose group were non-survivors, however we could not correlate the presence of lyso-PC with adverse l ong-term outcome in this group of preterm infants. (C) 1997 Elsevier S cience Ireland Ltd.