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Diagnosis of the respiratory distress syndrome (RDS) by the absence of phosphatidyldimethanolamine (PDME) in tracheal efluents of low birth weight (LBW) infants

PDME, an intermediate in the synthesis of surfact-active lecithin from lungs, was isolated from lipid extracts of tracheal effluent (“mucus”) obtained from hypopharynx, separated by thinlayer chromatography on precoated silica gel mylar strips and detected with bromothymol blue.PDME, arterial blood pH and rectal temperature were recorded seriall (½, 1, 2, 3, 4 hours of life) in 28 randomly selected LBW infants. Of 126 tests performed, the results at 3 hours correlated with diagnosis of RDS. PDME was absent in 14/16 infants with RDS, and PDME was present in 11/12 infants without RDS. There was a significant (p < 0.01) association between arterial blood pH and PDME:Little correlation was found between temperature and PDME. The results indicate that serial determinations of PDME may provide a rapid definite early chemical diagnosis of RDS.