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.

Artificial ventilation, Congenital diaphragmatic hernia, Extracorporeal membrane oxygenation, Persistent pulmonary hypertension, Prostacyclin, Thromboxane,
Mediators of Inflammation
Erasmus MC: University Medical Center Rotterdam

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