Partial liquid ventilation with surfactant: effects on gas exchange and lung pathology in surfactant-depleted piglets.

Abstract

OBJECTIVE:

To evaluate the effects of 24 h partial liquid ventilation (PLV) with and without surfactant (S) treatment on gas exchange and lung injury in a newborn animal model of S deficiency.

DESIGN:

A prospective, controlled, in vivo animal laboratory study.

SETTING:

Research laboratory in a university setting.

SUBJECTS:

Twenty-four pathogen-free, male piglets (mean weight 1.9 kg, age 1-3 days).

INTERVENTIONS:

The animals were randomised in four groups: PLV with FC-77 combined with conventional ventilation (PLV/CV) versus S + PLV/CV and PLV combined with high frequency oscillatory ventilation (PLV/HFOV) versus S + PLV/HFOV. The piglets were anaesthetised, intubated and instrumented with vascular catheters. Thirty minutes after lung injury had been induced with repeated saline lavage, S animals received natural S. Thirty minutes after surfactant substitution PLV with FC-77 was started. The oxygenation index (OI), PaO(2)/FIO(2) ratio, PaCO(2) and the ventilatory efficacy index were determined before and during PLV. After 24 h the lungs were removed for histopathological examination.

MEASUREMENTS AND MAIN RESULTS:

Within 60 min after the initiation of PLV, all animals demonstrated improvements of the OI and PaO(2)/FIO(2) ratio compared to the values after lung injury. However, at 18 and 24 h of PLV, the OI and PaO(2)/FIO(2) ratio were significantly worse in the S + PLV/CV and S + PLV/HFOV groups compared to the groups without S. PaCO(2) was higher at 18 and 24 h when S was used in PLV/HFOV (p < 0.05). A semi-quantitative lung injury score revealed most severe lung damage in the S + PLV/HFOV group. CONCLUSIONS++: The combination of S and PLV with FC-77 led to an impaired gas exchange and did not further protect the animal from lung injury.

• Authors: U Merz, M Kellinghaus, M Häusler, N Pakrawan, B Klosterhalfen, H Hörnchen
• Journal: Intensive care medicine (Intensive Care Med) Vol. 26 Issue 1 Pg. 109-16 (Jan 2000) ISSN: 0342-4642 [Print] United States
• PMID: 10663291 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Fluorocarbons
• Pulmonary Surfactants

Topics

• Animals
• Animals, Newborn
• Fluorocarbons (administration & dosage)
• Hemodynamics
• High-Frequency Ventilation
• Male
• Pulmonary Gas Exchange
• Pulmonary Surfactants (administration & dosage, deficiency)
• Respiration, Artificial (methods)
• Respiratory Insufficiency (pathology, therapy)
• Swine