title: Intratracheal surfactant administration restores gas exchange in experimental adult respiratory distress syndrome associated with viral pneumonia.
abstract: The effect of intratracheal surfactant administration was studied in rats with adult respiratory distress syndrome associated with infection with nebulized Sendai virus. Thirty-six hours after infection, animals (n = 7) showed severely impaired gas exchange and acidosis during artificial ventilation (PaO2 = 152.2 +/- 18.7, PaCO2 = 65.3 +/- 19.2, pH = 7.26 +/- 0.11) with a pressure-controlled mode, standard frequency of 35/min, peak airway pressure of 15 cm H2O (15/0), inspiratory/expiratory ratio of 1:2, and F1O2 = 1. Gas exchange improved (P = 0.02) with increased ventilator pressures with PEEP (25/4). Forty-eight hours after infection, blood gas tensions could no longer be significantly improved by these same ventilator settings (PaO2 = 123.8 +/- 31.0, PaCO2 = 95.1 +/- 43.6, pH = 7.12 +/- 0.16, n = 9). At this time, surfactant replacement dramatically increased arterial oxygenation within 5 min (PaO2 = 389.4 +/- 79.9) and resulted in a fourfold increase in PaO2 within 2 h. It is concluded that intratracheal surfactant administration is a promising approach in the treatment of respiratory failure during adult respiratory distress syndrome associated with viral pneumonia.
authors.affiliation: Department of Anesthesiology, Erasmus University, Rotterdam, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: van Daal
authors.forename: K L
authors.initials: KL
authors.lastname: So
authors.forename: D
authors.initials: D
authors.lastname: Gommers
authors.forename: E P
authors.initials: EP
authors.lastname: Eijking
authors.forename: R B
authors.initials: RB
authors.lastname: Fiévez
authors.forename: M J
authors.initials: MJ
authors.lastname: Sprenger
authors.forename: D W
authors.initials: DW
authors.lastname: van Dam
authors.forename: B
authors.initials: B
authors.lastname: Lachmann
mesh_terms: D000818:Animals; D006863:Hydrogen-Ion Concentration; D008168:Lung / Q000473:pathology; D008297:Male; D010222:Parainfluenza Virus 1, Human; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000473:pathology; D011024:Pneumonia, Viral / Q000150:complications* / Q000503:physiopathology; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000627:therapeutic use*; D051381:Rats; D011919:Rats, Inbred Strains; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000188:drug therapy; D014132:Trachea
chemical_list: D011663:Pulmonary Surfactants