Reduced levels of pulmonary surfactant in COVID-19 ARDS.

To provide novel data on surfactant levels in adult COVID-19 patients, we collected bronchoalveolar lavage fluid less than 72 h after intubation and used Fourier Transform Infrared Spectroscopy to measure levels of dipalmitoylphosphatidylcholine (DPPC). A total of eleven COVID-19 patients with moderate-to-severe ARDS (CARDS) and 15 healthy controls were included. CARDS patients had lower DPPC levels than healthy controls.

[Surfactant therapy of respiratory distress syndrome].

This review gives a summary of the development of a method to measure lung surfactant on gastric aspirate at birth in premature infants with the purpose to threat respiratory distress syndrome early with targeted surfactant. Machine learning was used to create the algorithm, and a point-of-care spectrometer was constructed for use in the delivery room. The sensitivity was 91% and specificity 79% in a clinical trial.

Bronchopulmonary dysplasia predicted at birth by artificial intelligence.

Aim: To develop a fast bedside test for prediction and early targeted intervention of bronchopulmonary dysplasia (BPD) to improve the outcome.

Methods: In a multicentre study of preterm infants with gestational age 24-31 weeks, clinical data present at birth were combined with spectral data of gastric aspirate samples taken at birth and analysed using artificial intelligence. The study was designed to develop an algorithm to predict development of BPD.

Predicting respiratory distress syndrome at birth using fast test based on spectroscopy of gastric aspirates. 1. Biochemical part.

Aim: To develop a fast bedside lung maturity test.

Methods: Gastric aspirates obtained from premature infants contain lamellar bodies, carrying lung surfactant. To estimate lung maturity, we isolated lamellar bodies from fresh gastric aspirates by centrifugation.

Predicting respiratory distress syndrome at birth using a fast test based on spectroscopy of gastric aspirates: 2. Clinical part.

Aim: To evaluate the accuracy of our new rapid point-of-care (POC) test for lung maturity. The method as we describe in an accompanying article was developed with the purpose of improving the outcome from respiratory distress syndrome (RDS). The test enables the delivery of surfactant in infants with immature lungs already at birth and ensures that infants with mature lungs are not treated unnecessarily.

Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity.

Aim: Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear, it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation.

Simultaneous determination of glucose, triglycerides, urea, cholesterol, albumin and total protein in human plasma by Fourier transform infrared spectroscopy: direct clinical biochemistry without reagents.

Objective: Direct measurement of chemical constituents in complex biologic matrices without the use of analyte specific reagents could be a step forward toward the simplification of clinical biochemistry. Problems related to reagents such as production errors, improper handling, and lot-to-lot variations would be eliminated as well as errors occurring during assay execution. We describe and validate a reagent free method for direct measurement of six analytes in human plasma based on Fourier-transform infrared spectroscopy (FTIR).

Early surfactant guided by lamellar body counts on gastric aspirate in very preterm infants.

Background: We have developed a rapid method, based on lamellar body counts (LBC) on gastric aspirate, for identifying newborns who will develop respiratory distress syndrome with a need for surfactant supplementation.

Objective: We set out to test whether it was possible to improve the outcome when used in a clinical trial.

Methods: We randomly assigned 380 infants born at 24-29 weeks' gestation and supported with nasal continuous positive airway pressure (nCPAP) to receive surfactant guided either by LBC (intervention group) or increasing need for oxygen (control group).

Airway effects of inhaled quaternary ammonium compounds in mice.

Quaternary ammonium compounds (QAC) constitute a family of widely used chemical substances. The QAC benzalkonium chloride (BAC) has caused bronchoconstriction in human beings by poorly understood mechanisms and lung damage at high concentration as shown in a single rat study. This study evaluates acute airway effects in mice after inhalation of aerosols of the QACs, BAC, hexadecyl trimethyl ammonium bromide (HTA), cetyl pyridinium chloride (CPC) and dimethyl dioctadecyl ammonium bromide (DDA).

Lamellar body counts on gastric aspirates for prediction of respiratory distress syndrome.

Aim: To develop a rapid method for diagnosing lung maturity at birth with the purpose of administering surfactant early to infants with immature lungs and to spare infants with mature lungs from this treatment.

Methods: Lamellar body counts (LBC) on gastric aspirates from 191 newborns were counted in the platelet window in automatic blood cell counters. A preliminary study was performed on 108 aspirates from 2000 in infants with <32 weeks' gestation.

Prophylactic or early selective surfactant combined with nCPAP in very preterm infants.

Objective: Early surfactant followed by extubation to nasal continuous positive airway pressure (nCPAP) compared with later surfactant and mechanical ventilation (MV) reduce the need for MV, air leaks, and bronchopulmonary dysplasia. This randomized, controlled trial investigated whether prophylactic surfactant followed by nCPAP compared with early nCPAP application with early selective surfactant would reduce the need for MV in the first 5 days of life.

Methods: A total of 208 inborn infants who were born at 25 to 28 weeks' gestation and were not intubated at birth were randomly assigned to prophylactic surfactant or nCPAP within 30 minutes of birth.

Nasal CPAP and surfactant for treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia.

Unlabelled: The Scandinavian approach is an effective combined treatment for respiratory distress syndrome (RDS) and prevention of bronchopulmonary dysplasia (BPD). It is composed of many individual parts. Of significant importance is the early treatment with nasal continuous positive airway pressure (nCPAP) and surfactant treatment.

Nasal CPAP has become an indispensable part of the primary treatment of newborns with respiratory distress syndrome.

Prenatal steroids, early nasal CPAP combined with early surfactant treatment followed by extubation to nasal CPAP, and if necessary mechanical ventilation is a very effective treatment of respiratory distress syndrome. This treatment package is part of the 'Scandinavian model' for treatment of very-low-birthweight infants which also comprises gentle ventilation at birth; minimal handling; 'neonatal individualized development care and assessment program'; high priority of breast feeding; and use of kangaroo method and which facilitates observation and nursing of sick premature infants and optimizes the possibility for early mother-child contact. The incidence of bronchopulmonary dysplasia seems to be less of a problem in centres preferring nasal CPAP as the primary treatment for respiratory distress syndrome.

[Epidermolysis bullosa simplex Dowling-Meara].

A clinical case of epidermolysis bullosa simplex Dowling-Meara (EBS-DM) is described in a girl from birth to 23 years of age. In the neonatal period the skin symptoms were very severe, with general blister formation and Nikolsky's phenomenon. With time the symptoms improved.

Extreme hyperbilirubinaemia in term and near-term infants in Denmark.

Aim: To determine the incidence amongst infants born at term or near-term of extreme hyperbilirubinaemia, i.e., with a serum concentration of unconjugated bilirubin exceeding the limit above which an exchange transfusion was indicated according to the authorized guidelines.

Perinatal risk factors of adverse outcome in very preterm children: a role of initial treatment of respiratory insufficiency?

Aim: To investigate risk factors of adverse outcome in a cohort of very preterm children treated mainly with nasal continuous positive airway pressure (CPAP) during the neonatal course.

Methods: In Denmark, preterm children are treated with nasal CPAP as a first approach to respiratory support. A national prospective study of all infants with a birthweight below 1000 g or a gestational age below 28 wk born in 1994-1995 was initiated to evaluate this approach.

Prediction of respiratory distress syndrome by the microbubble stability test on gastric aspirates in newborns of less than 32 weeks' gestation.

Aim: There is a need for a rapid method to identify infants who will develop respiratory distress syndrome (RDS) soon after birth, to allow early treatment of affected infants with surfactant. The microbubble stability test (MST) may be one such method, but clinical experience is sparse.

Methods: The MST was performed on gastric aspirates from 188 infants with a mean gestational age of 29 (range 23-31) wk.

[Neonatal mortality and morbidity in gestational age shorter than 30 weeks for babies treated primarily in a central hospital. Follow-up studies of an unselected, consecutive patient group].

Aim: The aim of the study was to investigate the mortality and morbidity of very premature babies treated at a Danish county hospital in the mid-1990s.

Materials And Method: The 62 survivors of 70 consecutive babies born in 1993-1997 were given a neuropaediatric follow-up examination at a corrected mean age of 49 (22-69) months. The mean gestational age was 27 (24-29) weeks and the mean birth weight was 1012 (550-1374) g.

Soluble intercellular adhesion molecule and C-reactive protein as early markers of infection in newborns.

In order to find a reliable early marker of infection in newborns a study with simultaneous determination of soluble Intercellular Adhesion Molecule-1 (sICAM-1) and C-Reactive Protein (CRP) was planned. Prospectively 90 babies < 5 days of age suspect of infection were included. Retrospectively this population was classified into an "infected" group (n = 45) and a "non-infected" group (n = 45).

Nasal continuous positive airway pressure and early surfactant therapy for respiratory distress syndrome in newborns of less than 30 weeks' gestation.

Objective: To determine whether early versus late treatment with porcine surfactant (Curosurf) reduces the requirement of mechanical ventilation in very preterm infants primarily supported by nasal continuous positive airway pressure (nasal CPAP).

Design: Multicenter randomized, controlled trial.

Patients: The study population comprised 60 infants <30 weeks' gestation with respiratory distress syndrome (RDS) who had an arterial to alveolar oxygen tension ratio (a/APO2) of 0.

[Neonatal mortality, morbidity and late sequelae in infants with birth weight under 1.501 gr or gestational age under 31 weeks, primarily admitted to a central hospital].

The purpose of the study was during a three year period from 1990 to 1992 to describe the neonatal mortality, morbidity and the late complications of 75 very low birth weight infants primarily treated in the neonatal department of a County Hospital. The study was performed retrospectively. The mean birth weight was 1292 g in (range 755-2046 g) and the mean gestational age 29.