Lung function and surfactant distribution in saline-lavaged sheep given instilled vs. nebulized surfactant.
Adult sheep (35 +/- 3 kg) underwent saline lung lavage and 1.5 h of mechanical ventilation to induce acute lung injury. Animals received 100 mg lipid/kg body wt of tracheally instilled surfactant (Inst Surf) or either nebulized surfactant (Neb Surf) or nebulized saline (Neb Saline) and were killed 3 h later. Inst Surf and Neb Surf groups had significant improvements in oxygenation (P < 0.01) and peak inspiratory pressures (PIP) (P < 0.05) compared with pretreatment values. Improvements in oxygenation and PIP for Inst Surf animals were significantly greater than for Neb Surf animals (P < 0.05). Volumes of maximal pressure of quasi-static pressure-volume curves measured at the time the animals were killed were significantly greater for Inst Surf and Neb Surf animals than for animals given Neb Saline (P < 0.05). Alveolar recovery of exogenous surfactant was 100 times greater for Inst Surf animals (1,732 +/- 70 mg) than for Neb Surf animals (15.3 +/- 2.9 mg) at the time they were killed. Although there were no differences in exogenous surfactant distribution patterns at the lobar level between the two surfactant-treated groups, distribution histograms calculated for 10-g lung pieces revealed the Neb Surf animals had significantly more pieces within 25% of the mean value of 1.0 (42.7 +/- 6.9%) than did Inst Surf animals (20.8 +/- 5.5%) (P < 0.01). Exogenous surfactant therapy improved lung function with significantly different quantities of surfactant deposited in lung tissue for the two delivery methods evaluated.
Lewis
J F
JF
Lawson Research Institute, St. Joseph's Health Centre, Department of Medicine, London, Ontario, Canada.
Tabor
B
B
Ikegami
M
M
Jobe
A H
AH
Joseph
M
M
Absolom
D
D
D000336:Aerosols; D000818:Animals; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000378:metabolism; D002417:Cattle; D006439:Hemodynamics / Q000502:physiology; D007442:Intubation, Intratracheal; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D010713:Phosphatidylcholines / Q000378:metabolism; D011652:Pulmonary Circulation / Q000187:drug effects; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000378:metabolism*; D012756:Sheep; D007507:Therapeutic Irrigation
D000336:Aerosols; D010713:Phosphatidylcholines; D011663:Pulmonary Surfactants; D002245:Carbon Dioxide