Exogenous surfactant function in very preterm lambs with and without fetal corticosteroid treatment.
We have asked whether the function of a bovine source surfactant frequently used clinically (Survanta) could be enhanced after exposure to the very preterm lung when the surfactant was subsequently tested in vivo in preterm surfactant-deficient rabbits. We also evaluated whether there would be effects resulting from fetal treatment with 0.5 mg/kg betamethasone given 48 h before delivery of lambs at 121 days gestational age. The fetal corticosteroid treatment significantly improved gas exchange, increased compliance, increased functional residual capacity, decreased vascular-to-alveolar protein leak, and increased static lung volumes. However, surfactant from both groups of lambs, recovered by alveolar wash and subsequently fractionated to recover the large-aggregate functional surfactant, was equivalent in function to the Survants given to the lambs when tested in preterm surfactant-deficient rabbits. Addition of plasma to Survanta resulted in high minimum surface tensions in vitro, and this inhibition could be prevented by supplementation of the Survanta with 5 or 10% sheep surfactant. No activation occurred with treatment of the very preterm lung, a result consistent with the lung being too immature to contribute components to the surfactant used for treatment. Fetal corticosteroid treatment had no effect on surfactant function at this gestational age.
Chen
C M
CM
Department of Pediatrics, Harbor-University of California Los Angeles Medical Center, Torrance 90509, USA.
Ikegami
M
M
Ueda
T
T
Polk
D H
DH
Jobe
A H
AH
D000305:Adrenal Cortex Hormones / Q000494:pharmacology*; D000818:Animals; D000831:Animals, Newborn / Q000502:physiology*; D001798:Blood Proteins / Q000037:antagonists & inhibitors; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D005260:Female; D005865:Gestational Age; D008168:Lung / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011663:Pulmonary Surfactants / Q000502:physiology*; D011817:Rabbits; D012756:Sheep; D013499:Surface Properties
D000305:Adrenal Cortex Hormones; D001798:Blood Proteins; D011663:Pulmonary Surfactants