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

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Abstract:

Abstract 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. Furthermore, 83 aspirates from 2004 to 2005 in infants with <30 weeks’ gestation were analysed. Results: 

Lamellar bodies in gastric aspirate were identified by electron microscopy. Seventy of the aspirates from 2004 to 2005 were analysed with a Sysmex XE-2100 (Sysmex, Holbæk, Næstved, Odense and Rigshospitalet, Denmark) counter. Twenty-four of these infants developed moderate to severe respiratory distress syndrome (RDS). The best cut-off value was 8000/μL with a sensitivity of 75% and a specificity of 72%. Forty-four of the 70 aspirates from 2004 to 2005 were analysed by Sysmex, Advia 120 and Cell-Dyn 4000. Thirteen other aspirates from 2004 to 05 were analysed by Sysmex and Coulter Counter LH755. Using Advia and Coulter the results were similar to Sysmex, but LBC obtained with Cell-Dyn were not correlated with the development of RDS. Conclusion: 

Lamellar body counts on gastric aspirate is a promising tool for prediction of development of RDS in infants of <30 weeks` gestation.

Keywords: Lamellar bodies; Lung surfactant; Prematurity; Respiratory distress syndrome

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1651-2227.2010.02010.x

Affiliations: 1: Department of Pediatrics, University of Copenhagen, Copenhagen, Denmark 2: Department of Pediatrics, University of Aalborg, Aalborg, Denmark 3: Department of Clinical Chemistry Holbæk University Hospital, University of Copenhagen, Copenhagen, Denmark 4: Department of Pediatrics Odense University Hospital, University of South Denmark, Odense, Denmark 5: Department of Pediatrics Århus University Hospital, University of Århus, Århus, Denmark 6: Department of Clinical Chemistry Aalborg University Hospital, University of Aalborg, Aalborg, Denmark 7: Department of Neonatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark 8: Department of Pediatrics Næstved Hospital, Næstved, Denmark

Publication date: February 1, 2011

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