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Background: Whether congenital diaphragmatic hernia (CDH) is associated with surfactant deficiency or dysfunction is controversial. Aims: To measure disaturated phosphatidylcholine (DSPC) and surfactant protein B (SP-B) synthesis and metabolism in infants with CDH. Methods: DSPC and SP-B amounts and kinetics were studied in tracheal aspirates (TA) of 12 infants with CDH (BW 2978±447g, GA 38±2 wk) and in 8 GA-matched control infants (BW 3160±350g, GA 38±2 wk). Seventeen infants received a 24h infusion of 13C-leucine, an i.v. bolus of 2H2O and 0.0625% of fluid intake as 2H2O every 12h over the next 48h. Three infants received only 13C-leucine infusion. DSPC and SP-B were isolated from TA. DSPC amounts, 2H-palmitate and 13C-leucine enrichments were measured by gas chromatography mass spectrometry. Results: DSPC amount and kinetics have been measured in 17 newborns, and SP-B kinetics in 18. DSPC median (interquartile range) fractional synthesis rate (FSR) was 5.0 %/day (3.5-8.5) in CDH patients vs 6.1 %/day (5.8-7.0) in controls (p=0.31). DSPC secretion time (ST) was 10.7h (6.9-11.5) vs 7.9h (5.2-14.0) (p=0.65). SP-B FSR was 33.4 %/day (28.4-42.9) vs 52.0 %/ day (40.0-83.4) (p=0.03); SP-B peak time was 26h (24-32) vs 18h (15-21) (p=0.02), both significantly lower in the CDH group. SP-B ST was 6.1h (4.0- 9.9) vs 2.7h (1.1-7.1) (p=0.24), and half life 7.5h (5.2-9.1) vs 11.1h (5.8-17.3) (p=0.33). Conclusions: Decreased and delayed SP-B synthesis was found in newborns with CDH compared to controls while DSPC kinetics was similar in both groups, which may contribute to severe respiratory failure in these patients.

LUNG MECHANICS IN NEWBORN INFANTS WITH SEVERE CONGENITAL DIAPHRAGMATIC HERNIA (CDH) BEFORE AND AFTER SURGICAL REPAIR

Thrombopoietin (Tpo) Levels are High in the Plasma of Thrombocytopenic Sick Neonates and Correlate Inversely with the Number of Platelets (PLT) † 1388

Routine Bronchoalveolar Lavage (BAL) Cultures for the Prediction of Ventilator-Associated Pneumonia 1437

A CASE OF CONGENITAL AUTOIMMUNE DIABETES: LOSS OF IMMUNE TOLERANCE CAN START IN INTRAUTERINE LIFE. 54

An apparatus was deviced allowing to shift from CPAP breathing by nasal prongs to nasal IPPV upon activation of the alarm of bradycardia (HR 20 sec (0-13% vs 43-62%); higher minimum HR (m 68-75/min vs 53-58/min). In the remaining 2 infants no significant differences were observed.

ABSENCE OF NECROTIZING ENTEROCOLYTIS (NEC) IN SEPTIC LOW BIRTHWEIGHT INFANTS TREATED BY POLYMORPHONUCLEAR LEUKOCYTES (PMNs) TRANSFUSIONS