Vasoactive prostanoids may be involved in persistent pulmonary hypertension (PPH) in infants with a congenital diaphragmatic hernia (CDH). We hypothesized that increased levels of prostanoids in bronchoalveolar lavage (BAL) fluid would predict clinical outcome. We measured the concentrations of 6-keto-prostaglandin F(1α) (6-keto-PGF(1α)), thromboxane B2(TxB2), protein, albumin, total cell count, and elastase-α1- proteinase-inhibitor complex in BAL fluid of 18 CDH patients and of 13 control subjects without PPH. We found different concentrations of prostanoids in BAL fluid of CDH patients with PPH: infants with a poor prognosis had either high levels of both 6-keto-PGF(1α) and TxB2compared to controls, or high levels of 6-keto-PGF1'α only. TxB2levels showed a large variability in all CDH patients irrespective of outcome. We conclude that prostanoid levels in BAL fluid do not predict clinical outcome in CDH patients.

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Keywords Artificial ventilation, Congenital diaphragmatic hernia, Extracorporeal membrane oxygenation, Persistent pulmonary hypertension, Prostacyclin, Thromboxane
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Journal Mediators of Inflammation
IJsselstijn, H, Zijlstra, F.J, de Jongste, J.C, & Tibboel, D. (1997). Prostanoids in bronchoalveolar lavage fluid do not predict outcome in congenital diaphragmatic hernia patients. Mediators of Inflammation, 6(3), 217–224. doi:10.1080/09629359791712