Surfactant lung lavage using asymmetric high-frequency jet ventilation followed by conventional ventilation in rabbits with meconium aspiration.

Abstract

BACKGROUND:

Severe impairment of lung functions in meconium aspiration syndrome (MAS) often needs the application of combined therapeutic approach. In our recent study, surfactant lung lavage during asymmetric high-frequency jet ventilation (HFJV) removed more meconium than surfactant lavage during conventional ventilation, however, after the lavage excessive CO2 elimination was observed during HFJV.

OBJECTIVES:

We hypothesized that the combination of asymmetric HFJV during surfactant lung lavage and conventional ventilation in the post-lavage period may be of benefit in a rabbit model of MAS.

METHODS:

Suspension of human meconium in saline (25 mg/ml, 4 ml/kg) was instilled into the tracheal tube of conventionally ventilated (frequency, f, 30/min, inspiration time, Ti, 50%) anesthetized rabbits to cause a respiratory failure. Animals were then lavaged (10 ml/kg in 3 portions) with diluted surfactant (Curosurf, 100 mg of phospholipids/ml) or saline during asymmetric HFJV (f, 300/min, Ti, 70%). After the lavage, animals were ventilated conventionally (f, 30/min, Ti, 50%) for next 1 hour.

RESULTS:

Surfactant lung lavage during asymmetric HFJV removed more meconium pigments and solids than saline with HFJV (p < 0.05 or p < 0.01, respectively). Moreover, application of asymmetric HFJV facilitated the lavage fluid removal in both groups. In the post-lavage period, improved oxygenation, lung compliance, right-to-left pulmonary shunts, and reduced ventilatory requirements were found in the surfactant group (p < 0.05), while pCO2 was kept in the normal range.

CONCLUSIONS:

Surfactant lung lavage by asymmetric HFJV followed by conventional ventilation is advantageous combination in rabbits with MAS and may be tested in neonatal MAS (Tab. 2, Fig. 2, Ref. 12).

• Authors: D Mokra, A Calkovska, A Drgova, K Javorka
• Journal: Bratislavske lekarske listy (Bratisl Lek Listy) Vol. 106 Issue 12 Pg. 412-5 ( 2005) ISSN: 0006-9248 [Print] Slovakia
• PMID: 16642667 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biological Products
• Phospholipids
• Pulmonary Surfactants
• poractant alfa

Topics

• Animals
• Biological Products (administration & dosage)
• Bronchoalveolar Lavage
• High-Frequency Jet Ventilation
• Humans
• Infant, Newborn
• Meconium Aspiration Syndrome (therapy)
• Phospholipids (administration & dosage)
• Pulmonary Surfactants (administration & dosage)
• Rabbits
• Respiration, Artificial