Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane Disease
Background:Early treatment with exogenous surfactant is associated with better outcome in neonates with Hyaline membrane disease (HMD), but diagnosis may only become clear late in the course of the disease. In order to rapidly and reliably identify such neonates, we have evaluated the Gastric aspira...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | fas |
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Isfahan University of Medical Sciences
2009-07-01
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| Series: | مجله دانشکده پزشکی اصفهان |
| Online Access: | http://jims.mui.ac.ir/index.php/jims/article/view/241 |
| _version_ | 1797760906575216640 |
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| author | Mansour Mohammadi Ramin Iranpour Majid Mohammadizadeh Bahram Soleymani Mehnosh Hajiheydari |
| author_facet | Mansour Mohammadi Ramin Iranpour Majid Mohammadizadeh Bahram Soleymani Mehnosh Hajiheydari |
| author_sort | Mansour Mohammadi |
| collection | DOAJ |
| description | Background:Early treatment with exogenous surfactant is associated with better outcome in neonates with Hyaline membrane disease (HMD), but diagnosis may only become clear late in the course of the disease. In order to rapidly and reliably identify such neonates, we have evaluated the Gastric aspirate shake test (GAST).
Methods:Eighty one neonates with gestational age less than 34 weeks enrolled to this study (51 newborns without pulmonary diseases and 31 newborns with HMD). The clinical characteristics of HMD considered as the gold standard of diagnosis. About 1 ml mixture of normal saline (0.5ml) and stomach contents were collected within 30 minutes of birth (0.5ml) were shaking for 15 seconds into a glass test tube. Then 1 ml of 95% ethanol was injected into the test tube and the 2 ml mixture of gastric aspirate, saline and alcohol agitated for a further 15 seconds. After a waiting time of 15 min, the surface of fluid was examined for bubbles to decide the result of shake test. If no bubbles were present then the test was NEGATIVE (very little surfactant). If bubbles were seen around the top of the fluid but not enough bubbles were present to completely cover the surface, then the test was INTERMEDIATE (only some surfactant). If bubbles were present right across the surface of the fluid, then the test was POSITIVE (adequate amounts of surfactant).
Findings: All infants who developed HMD had negative or intermediate test results. The GAST had a specificity of 66%, sensitivity of 100%, positive predictive value of 64.5% and negative predictive value of 100% for developing HMD. The sensitivity and specificity of the GAST for prediction of surfactant requirement in HMD patients were 100% and 64.8%, respectively, with a positive and negative predictive value of 62.5% and 100%, respectively.
Conclusion: We conclude that the GAST on gastric aspirates obtained within 0.5 hour of delivery is a rapid and simple procedure for rule out of HMD and surfactant requirement.
Key words:Gastric aspirate shake test, Hyaline membrane disease, Surfactant, Neonate. |
| first_indexed | 2024-03-12T19:05:18Z |
| format | Article |
| id | doaj.art-6e57800343aa4372b337421b29018768 |
| institution | Directory Open Access Journal |
| issn | 1027-7595 1735-854X |
| language | fas |
| last_indexed | 2024-03-12T19:05:18Z |
| publishDate | 2009-07-01 |
| publisher | Isfahan University of Medical Sciences |
| record_format | Article |
| series | مجله دانشکده پزشکی اصفهان |
| spelling | doaj.art-6e57800343aa4372b337421b290187682023-08-02T06:18:52ZfasIsfahan University of Medical Sciencesمجله دانشکده پزشکی اصفهان1027-75951735-854X2009-07-012796307316234Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane DiseaseMansour Mohammadi0Ramin Iranpour1Majid Mohammadizadeh2Bahram Soleymani3Mehnosh Hajiheydari4Fellowship of Neonatology, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, IsfahanAssociat Professor of Neonatology, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, IsfahanAssociat Professor of Neonatology, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, IsfahanAssistant Professor of Biostatistics, Azad Islamic University, Nazaf-Abad branch, IsfahanHeadnurse of Neonatology Ward. Beheshti Hospital, Isfahan University of Medical Sciences, IsfahanBackground:Early treatment with exogenous surfactant is associated with better outcome in neonates with Hyaline membrane disease (HMD), but diagnosis may only become clear late in the course of the disease. In order to rapidly and reliably identify such neonates, we have evaluated the Gastric aspirate shake test (GAST). Methods:Eighty one neonates with gestational age less than 34 weeks enrolled to this study (51 newborns without pulmonary diseases and 31 newborns with HMD). The clinical characteristics of HMD considered as the gold standard of diagnosis. About 1 ml mixture of normal saline (0.5ml) and stomach contents were collected within 30 minutes of birth (0.5ml) were shaking for 15 seconds into a glass test tube. Then 1 ml of 95% ethanol was injected into the test tube and the 2 ml mixture of gastric aspirate, saline and alcohol agitated for a further 15 seconds. After a waiting time of 15 min, the surface of fluid was examined for bubbles to decide the result of shake test. If no bubbles were present then the test was NEGATIVE (very little surfactant). If bubbles were seen around the top of the fluid but not enough bubbles were present to completely cover the surface, then the test was INTERMEDIATE (only some surfactant). If bubbles were present right across the surface of the fluid, then the test was POSITIVE (adequate amounts of surfactant). Findings: All infants who developed HMD had negative or intermediate test results. The GAST had a specificity of 66%, sensitivity of 100%, positive predictive value of 64.5% and negative predictive value of 100% for developing HMD. The sensitivity and specificity of the GAST for prediction of surfactant requirement in HMD patients were 100% and 64.8%, respectively, with a positive and negative predictive value of 62.5% and 100%, respectively. Conclusion: We conclude that the GAST on gastric aspirates obtained within 0.5 hour of delivery is a rapid and simple procedure for rule out of HMD and surfactant requirement. Key words:Gastric aspirate shake test, Hyaline membrane disease, Surfactant, Neonate.http://jims.mui.ac.ir/index.php/jims/article/view/241 |
| spellingShingle | Mansour Mohammadi Ramin Iranpour Majid Mohammadizadeh Bahram Soleymani Mehnosh Hajiheydari Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane Disease مجله دانشکده پزشکی اصفهان |
| title | Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane Disease |
| title_full | Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane Disease |
| title_fullStr | Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane Disease |
| title_full_unstemmed | Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane Disease |
| title_short | Gastric Aspirate Shake Test for Predicting of Surfactant Therapy in Premature Neonates with Hyaline Membrane Disease |
| title_sort | gastric aspirate shake test for predicting of surfactant therapy in premature neonates with hyaline membrane disease |
| url | http://jims.mui.ac.ir/index.php/jims/article/view/241 |
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