{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:14:29Z","timestamp":1763640869158,"version":"3.40.5"},"reference-count":47,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,5,1]]},"abstract":"<jats:p>Objective.\u2003To determine whether number and activation of circulating polymorphonuclear leukocytes (PMNs) and platelets are associated with disease severity in neonatal respiratory distress syndrome (RDS).<\/jats:p><jats:p>Design.\u2003Prospective study.<\/jats:p><jats:p>Setting.\u2003Tertiary neonatal intensive care unit.<\/jats:p><jats:p>Patients.\u2003Preterm infants with severe (n = 18) or mild to moderate (n = 18) RDS who were consecutively admitted.<\/jats:p><jats:p>Interventions.\u2003PMN and platelet counts and plasma concentrations of elastase-\u03b11-proteinase inhibitor (E-\u03b11-PI) and thromboxane B2(TxB2) were recorded each day during the first 5 days of life. E-\u03b11-PI-to-PMN and TxB2-to-platelet ratios were calculated to correct for the influence of the PMN and platelet count on elastase and thromboxane release.<\/jats:p><jats:p>Results.\u2003From day 2, the severe RDS group had lower median PMN counts (1.5 vs 4.5 \u00d7 109\/L), lower mean platelet counts (136 vs 230 \u00d7 109\/L), and more elastase and thromboxane release, indicated by higher median E-\u03b11-PI-to-PMN (39.2 vs 13.0 ng\/106 PMNs on day 2) and TxB2-to-platelet (2.61 vs 0.52 pg\/106 platelets on day 3) ratios than the mild-to-moderate group. Lower PMN and platelet counts and higher elastase and thromboxane release were correlated with birth asphyxia (lower 5-minute Apgar scores and umbilical arterial PH values), higher respiratory requirements (fraction of inspired oxygen and peak inspiratory pressure), and decreased values for continuous measures of RDS severity (ventilatory efficiency index and Pao2-to-alveolar oxygen tension ratio).<\/jats:p><jats:p>Conclusion.\u2003Decreased PMN and platelet counts and increased elastase and thromboxane release are correlated with increased RDS severity. Birth asphyxia (hypoxia and acidosis) and tissue injury caused by high-pressure ventilation and hyperoxia may promote this activation process.<\/jats:p>","DOI":"10.1542\/peds.99.5.672","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:40:17Z","timestamp":1092440417000},"page":"672-680","source":"Crossref","is-referenced-by-count":27,"title":["Number and Activation of Circulating Polymorphonuclear Leukocytes and Platelets Are Associated with Neonatal Respiratory Distress Syndrome Severity"],"prefix":"10.1542","volume":"99","author":[{"given":"Frank","family":"Brus","sequence":"first","affiliation":[{"name":"From the Beatrix Children's Hospital, Division of Neonatology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem","family":"van Oeveren","sequence":"additional","affiliation":[{"name":"Department of Cardiopulmonary Surgery, Division of Blood Interaction Research, University Hospital Groningen, University of Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Okken","sequence":"additional","affiliation":[{"name":"From the Beatrix Children's Hospital, Division of Neonatology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidarto Bambang","family":"Oetomo","sequence":"additional","affiliation":[{"name":"From the Beatrix Children's Hospital, Division of Neonatology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[1997,5,1]]},"reference":[{"key":"2021121009532376000_B1","first-page":"817","article-title":"Neonatal lung neutrophils and elastase\/proteinase inhibitor imbalance.","volume":"130","author":"Ogden","year":"1984","journal-title":"Am Rev Respir Dis"},{"key":"2021121009532376000_B2","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1172\/JCI111015","article-title":"Elastase and \u03b1-1-proteinase inhibitor activity in tracheal aspirates during respiratory distress syndrome.","volume":"72","author":"Merritt","year":"1983","journal-title":"J Clin Invest."},{"key":"2021121009532376000_B3","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1542\/peds.93.5.712","article-title":"Association of pulmonary inflammation and increased microvascular permeability during the development of bronchopulmonary dysplasia: a sequential analysis of inflammatory mediators in respiratory fluids of high-risk preterm neonates.","volume":"93","author":"Groneck","year":"1994","journal-title":"Pediatrics"},{"key":"2021121009532376000_B4","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/S0022-3476(09)90024-5","article-title":"Effects of dexamethasone on chemotactic activity and inflammatory mediators in tracheobronchial aspirates of preterm infants at risk for chronic lung disease.","volume":"122","author":"Groneck","year":"1993","journal-title":"J Pediatr"},{"key":"2021121009532376000_B5","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1164\/ajrccm\/141.2.471","article-title":"Macrophages and polymorphonuclear neutrophils in lung defense and injury.","volume":"141","author":"Sibille","year":"1990","journal-title":"Am Rev Respir Dis"},{"key":"2021121009532376000_B6","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1542\/peds.91.4.794","article-title":"Neutrophil elastase and acute pulmonary damage in neonates with severe respiratory distress syndrome.","volume":"91","author":"Speer","year":"1993","journal-title":"Pediatrics"},{"key":"2021121009532376000_B7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1136\/thx.47.1.44","article-title":"Tumor necrosis factor in the bronchoalveolar secretions of infants with the respiratory distress syndrome and the effect of dexamethasone treatment.","volume":"47","author":"Murch","year":"1992","journal-title":"Thorax"},{"key":"2021121009532376000_B8","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1164\/ajrccm\/136.3.770","article-title":"Potential role of eicosanoids and PAF in the pathophysiology of bronchopulmonary dysplasia.","volume":"136","author":"Stenmark","year":"1987","journal-title":"Am Rev Respir Dis"},{"key":"2021121009532376000_B9","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1164\/ajrccm\/137.6.1364","article-title":"Tumor necrosis factor causes increased pulmonary permeability and edema. 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