Surface tension of airway aspirates withdrawn during neonatal resuscitation reflects lung maturity

Guido Stichtenoth*, Gabi Walter, Romy Lange, Marco Raith, Wolfgang Bernhard, Egbert Herting

*Corresponding author for this work
6 Citations (Scopus)


The indications for treatment of neonates with exogenous pulmonary surfactant are still discussed controversially. Some premature neonates are sufficiently treated by CPAP, others need conventional ventilation and/or surfactant. The available lung maturity tests have limitations. The captive bubble surfactometer (CBS) provides measurement of surface activity from rather small amounts of surfactant. This study aimed to determine surface activity from small volume aspirates of the upper airways of neonates by means of the CBS and to correlate the results with clinical data. Small upper airway aspirates from 159 neonates (gestational age 25-42 weeks) were withdrawn and concentrated 16.7-fold by ultracentrifugation and resuspension in saline. Surface activities after 5 min of adsorption were determined in the CBS and correlated to the perinatal data (e.g., gestational age, birth weight, gender), airway interventions (like CPAP, conventional ventilation) and surfactant treatment. Additionally, 27 samples were analyzed for surfactant specific phosphatidylcholine concentrations by using electrospray ionization tandem mass-spectroscopy. Surface activities show a significant correlation to gestational age, birth weight, and the need for airway interventions. Comparing the need for airway interventions versus surface activity, a receiver operating characteristic calculated a sensitivity of 0.77 and a specificity of 0.72 at a "cut off" of 44 mN/m. Surface activity correlates significantly with the phosphatidylcholine concentrations and the latter one correlates with the gestational age. Determination of surface activity from upper airway aspirates is feasible. Further clinical studies are needed to prove the predictive value of the method.

Original languageEnglish
JournalPediatric Pulmonology
Issue number8
Pages (from-to)751-756
Number of pages6
Publication statusPublished - 08.2014

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)


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