Ventilation-perfusion relationships in preterm infants after surfactant treatment.
Arterial-alveolar partial pressure differences for oxygen, carbon dioxide, and nitrogen were measured before and after surfactant replacement therapy on 15 occasions in 14 ventilator-dependent preterm infants with hyaline membrane disease (HMD). Eight treatments resulted in a significant improvement in arterial partial pressure of oxygen (PaO2) 2 hr after treatment; 7 did not. Neither group showed any significant change in arterial-alveolar partial pressure differences for oxygen, nitrogen, and carbon dioxide. This observation suggests that if surfactant replacement therapy produces an improvement in PaO2 it does so by recruitment of atelectatic alveoli with a balanced ventilation/perfusion ratio rather than by redistribution of ventilation within already ventilated alveoli.
Bowen
W
W
Department of Pediatrics, New York Hospital, Cornell Medical Center, New York 10021.
Martin
C R
CR
Krauss
A N
AN
Auld
P A
PA
D001688:Biological Products; D002245:Carbon Dioxide / Q000097:blood; D006801:Humans; D006819:Hyaline Membrane Disease / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood; D011650:Pulmonary Alveoli / Q000187:drug effects; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D011663:Pulmonary Surfactants / Q000494:pharmacology / Q000627:therapeutic use*; D014692:Ventilation-Perfusion Ratio / Q000187:drug effects*
D001688:Biological Products; D011663:Pulmonary Surfactants; D002245:Carbon Dioxide; C072197:beractant; D010100:Oxygen