Exogenous surfactant administration by asymmetric high-frequency jet ventilation in experimental respiratory distress syndrome.

Abstract

AIM:

To evaluate the efficacy of surfactant administration using the instillation technique by means of asymmetric high-frequency jet ventilation (HFJV).

METHODS:

Experiments were carried out on tracheotomized, anaesthetized, and paralyzed rabbits. Animals were lung-lavaged with saline and conventionally ventilated with 100% oxygen. After respiratory failure, they were ventilated for additional 2 hours with conventional ventilation (f=30/min) or HFJV (f=300/min). Subgroups were treated with porcine surfactant (Curosurf; 80 mg/mL, dose 200 mg/kg) as a bolus followed by conventional ventilation or instilled into the jet of the ventilator during asymmetric HFJV (inspiration time Ti=30%). In controls, no material was instilled.

RESULTS:

Bolus administration of Curosurf followed by conventional ventilation in comparison with conventionally ventilated animals without surfactant improved gas exchange (at 60 minutes: PaO(2)/FiO(2), 9.8-/+3.6 vs 22.3-/+8.5 kPa, P=0.020), reduced right-to-left pulmonary shunts (at 60 minutes: 47.8-/+13.8 vs 23.9-/+6.7 %, P<0.006), and reduced inflammatory response in the lungs. Surfactant administration by HFJV in comparison with bolus instillation resulted in even better gas exchange (at 90 minutes: 20.7-/+8.8 vs 39.1-/+10.9 kPa, P=0.005) and reduction of right-to-left pulmonary shunts (at 90 minutes: 29.1-/+7.2 vs 8.0-/+2.2 %, P=0.008). High-frequency jet ventilation with or without surfactant treatment significantly increased pressure-volume recordings and reduced intraalveolar edema in comparison with conventional ventilation-only group. There were no significant differences in inflammatory response between the two tested methods.

CONCLUSION:

The response to surfactant therapy in experimental lung injury depends on the surfactant delivery method and may be potentiated by high-frequency jet ventilation.

• Authors: Andrea Calkovska, Daniela Sevecova-Mokra, Kamil Javorka, Maria Petraskova, Katarina Adamicova
• Journal: Croatian medical journal (Croat Med J) Vol. 46 Issue 2 Pg. 209-17 (Apr 2005) ISSN: 0353-9504 [Print] Croatia
• PMID: 15849841 (Publication Type: Journal Article)

Chemical References

• Pulmonary Surfactants

Topics

• Animals
• Female
• High-Frequency Jet Ventilation
• Male
• Models, Animal
• Pulmonary Surfactants (administration & dosage)
• Rabbits
• Respiratory Distress Syndrome (drug therapy)
• Treatment Outcome