The development of
acute respiratory distress syndrome (ARDS) is known to be independently attributable to aspiration-induced
lung injury.
Mechanical ventilation as a high pressure/volume support to maintain sufficient oxygenation of a patient could initiate
ventilator-induced lung injury (VILI) and thus contribute to lung damage. Although these phenomena are rare in the clinic, they could serve as the severe experimental model of alveolar-capillary membrane deterioration.
Lung collapse, diffuse
inflammation, alveolar epithelial and endothelial damage, leakage of fluid into the alveoli, and subsequent inactivation of
pulmonary surfactant, leading to
respiratory failure. Therefore, exogenous
surfactant could be considered as a
therapy to restore lung function in experimental ARDS. This study aimed to investigate the effect of modified porcine
surfactant in animal model of severe ARDS (P/F ratio </=13.3 kPa) induced by intratracheal instillation of
hydrochloric acid (HCl, 3 ml/kg, pH 1.25) followed by VILI (V(T) 20 ml/kg). Adult rabbits were divided into three groups: untreated ARDS, model treated with a bolus of
poractant alfa (Curosurf®, 2.5 ml/kg, 80 mg
phospholipids/ml), and healthy ventilated animals (saline), which were
oxygen-ventilated for an additional 4 h. The lung function parameters, histological appearance, degree of lung
edema and levels of inflammatory and oxidative markers in plasma were evaluated. Whereas
surfactant therapy with
poractant alfa improved lung function, attenuated
inflammation and lung
edema, and partially regenerated significant changes in lung architecture compared to untreated controls. This study indicates a potential of exogenous
surfactant preparation in the treatment of experimental ARDS.