Decreased sodium ion absorption across nasal epithelium of very premature infants with respiratory distress syndrome

• Published in: The Journal of pediatrics 1997-03, Vol.130 (3), p.373-377
• Main Authors: Barker, Pierre M., Gowen, C.W., Lawson, Edward E., Knowles, Michael R.
• Format: Article
• Language: English
• Subjects: Amiloride - pharmacology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biological Transport, Active; Birth Weight; Case-Control Studies; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Humans; Infant, Newborn; Infant, Premature; Intensive care medicine; Medical sciences; Nasal Mucosa - metabolism; Respiratory Distress Syndrome, Newborn - etiology; Respiratory Distress Syndrome, Newborn - metabolism; Respiratory Distress Syndrome, Newborn - therapy; Sodium - metabolism; Sodium Channel Blockers; Sodium Channels - metabolism
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(97)70198-7

Objective and study design: Successful adaptation to air breathing at birth depends on rapid absorption of fetal lung liquid that is mediated by activation of amiloride-sensitive sodium ion channels. To test the relationship between respiratory epithelial Na + transport and development of respiratory distress syndrome (RDS), we measured nasal transepithelial potential difference (PD) in 31 very premature (≤30 weeks of gestation) newborn infants. Infants were retrospectively assigned to RDS (22 infants) and non-RDS (9 infants) groups on the basis of clinical and chest x-ray criteria. Results: Maximal nasal epithelial PD increased with birth weight (−1.2 mV/100 gm) and was lower in infants with RDS (−16.5 ± 0.6 mV) than in those without RDS (−22.0 ± 1.3 mV). Infants without RDS had PD values similar to normal fullterm infants. Amiloride inhibition of PD, an index of Na + absorption,, was significantly lower, within the first 24 hours of life, in infants in whom RDS developed (3.8 ± 0.2 mV; 29.5% ± 0.8% inhibition) than in those without RDS (6.1 ± 0.6 mV; 38.6% ± 0.5% inhibition). Maximal and amiloride-sensitive PD returned to normal during the recovery phase of RDS. Conclusions: We conclude that Na + absorption across nasal epithelium increases with increasing birth weight and that impairment of Na + absorption across the respiratory epithelia of very premature infants may contribute to the pathogenesis of RDS.