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Related Experiment Videos

Abnormal surfactant composition and activity in severe bronchiolitis.

R Skelton1, P Holland, M Darowski

  • 1Department of Paediatrics, General Infirmary at Leeds, UK.

Acta Paediatrica (Oslo, Norway : 1992)
|October 16, 1999
PubMed
Summary

Severe viral bronchiolitis in infants significantly reduces lung surfactant activity, linked to altered phospholipids. Activity and phosphatidylglycerol levels improve with recovery, suggesting targeted surfactant therapy may help.

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Area of Science:

  • Pediatric Intensive Care
  • Respiratory Medicine
  • Biochemistry

Background:

  • Severe viral bronchiolitis is a common respiratory illness in infants.
  • Mechanical ventilation is often required for severe cases.
  • The role of pulmonary surfactant in bronchiolitis is not fully understood.

Purpose of the Study:

  • To investigate surfactant activity and composition in infants with severe viral bronchiolitis.
  • To correlate surfactant changes with clinical status and coexisting conditions.
  • To inform potential therapeutic strategies, such as surfactant administration.

Main Methods:

  • Prospective study in four pediatric intensive care units.
  • Analysis of lung lavage fluid from infants with bronchiolitis, bronchiolitis plus comorbidities, and controls.

Related Experiment Videos

  • Assessment of surfactant activity using the "click test" and measurement of phospholipids, including phosphatidylglycerol (PG).

    • Main Results:

    • Surfactant activity was present in all controls but significantly reduced in infants with bronchiolitis alone (2/24).
    • Reduced surfactant activity correlated with decreased phosphatidylglycerol levels, indicating altered surfactant lipid composition.
    • In infants with coexisting conditions (sepsis/cardiac failure), surfactant deficiency was less consistent.
    • Surfactant activity and PG levels normalized by the time of extubation.

    Conclusions:

    • Severe viral bronchiolitis is associated with absent or reduced pulmonary surfactant activity and phosphatidylglycerol.
    • These surfactant abnormalities resolve with clinical recovery.
    • Infants with coexisting conditions may not always exhibit surfactant deficiency.
    • Surfactant administration could be beneficial but requires a selective approach based on individual patient status.