Diagnostic value of gastric shake test for hyaline membrane disease in preterm infant

Background: Hyaline membrane disease (HMD) has remained a common neonatal problem and is a cause of morbidity in infants. The shake test can be used to assess whether surfactant is present in the infant's lungs at birth.

Objective: The goal of this study was to determine the usefulness and accuracy of gastric aspirate shake test for the diagnosis of two HMD.

Materials and methods: This was a diagnostic accuracy study carried out on 49 preterm infant born at Shahid Sadoughi hospital in 2012 (25 newborns without pulmonary diseases and 24 newborns with HMD). Shortly after birth, the shake test was performed using gastric fluid. The results of the shake test were correlated with definitive diagnosis of HMD.

Results: All infants who developed HMD had negative test results. In 23 of 25 infants with no respiratory distress, the test was positive. Our findings indicated that the gastric aspirate shake test has 100% sensitivity, 92% specificity, a 92.3% predictive value for surfactant deficiency, and 100% predictive value for surfactant sufficiency.

Conclusion: According to this study gastric shake test (GST) is a reliable test and is a simple procedure to identify those neonates who will develop respiratory distress syndrome (RDS) and therefore to decide prophylactic exogenous surfactant replacement.