PROSTANOIDS IN BRONCHOALVEOLAR LAVAGE FLUID DO NOT PREDICT OUTCOME INCONGENITAL DIAPHRAGMATIC-HERNIA PATIENTS

Vasoactive prostanoids may be involved in persistent pulmonary hyperte nsion (PPH) in infants with a congenital diaphragmatic hernia (CDH). w e hypothesized that increased levels of prostanoids in bronchoalveolar lavage (BAL) fluid would predict clinical outcome. We measured the co ncentrations of 6-keto-prostaglandin F-1 alpha (6-keto-PGF(1 alpha)), thromboxane B-2 (TxB(2)), protein, albumin, total cell count, and elas tase-alpha(1)-proteinase-inhibitor complex in BAL fluid of 18 CDH pati ents and of 13 control subjects without PPH. Wie found different conce ntrations of prostanoids in BAL fluid of CDH patients with PPH: infant s with a poor prognosis had either high levels of both 6-keto-PGF(1 al pha) and TxB(2) compared to controls, or high levels of 6-keto-PGF(1 a lpha) only. TxB(2) levels showed a large variability in all CDH patien ts irrespective of outcome. We conclude that prostanoid levels in BAL fluid do not predict clinical outcome in CDH patients.