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Vascular endothelial growth factor (VEGF) in tracheal aspirates from preterm infants: effect of surfactant therapy
  1. A Purohit1,
  2. R Mehta2,
  3. A Petrova2
  1. 1Jersey Shore University medical Center, Neptune, USA
  2. 2Robert Wood University, New Brunswick, USA

Abstract

Objectives Vascular endothelial growth factor (VEGF) regulates vascular endothelial cell differentiation and angiogenesis, and maturation of epithelial cells of the developing lungs. Different reports have described the role of VEGF in lung cells proliferation, differentiation, growth and permeability. No study investigated effect of surfactant administration on lung VEGF production. This study investigated the effects of surfactant administration on the level of VEGF in tracheal aspiration fluid (TAF) of very preterm born infants.

Methods The change in TAF VEGF levels within 20–24 h after administration of the first dose of exogenous surfactant was studied in preterm born infants with respiratory distress syndrome who were intubated on day 1 of life. Multiple regression analysis was used to identify the independent effect of pulmonary VEGF concentration on the number of surfactant treatments, duration of ventilation and development of bronchopulmonary dysplasia (BPD).

Results VEGF levels prior to and after the surfactant administration were studied in 31 preterm infants with gestational age 23–35 week (29.5±3.3 weeks). TAF VEGF levels increased within 20–24 h after surfactant administration as compared to the baseline in all infants (40.0±42.5 pg/ml vs 55.0±43.8 pg/ml, p<0.001). TAF VEGF levels were indirectly associated with the gestational age (p<0.01), but did not independently impact the number of surfactant treatments, duration of ventilation and development of BPD.

Conclusion VEGF in tracheal aspirate increases in association with exogenous surfactant therapy; however, there is limited evidence regarding the impact of VEGF on the requirements for additional surfactant doses, duration of ventilation and development of BPD.

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