title: Rapid tracheal infusion of surfactant versus bolus instillation in rabbits: effects on oxygenation, blood pressure and surfactant distribution.
abstract: Surfactant bolus instillation may be associated with a drop in blood pressure. Platelet-activating factor (PAF) has been found in surfactant preparations. The aim of this study was to evaluate rapid tracheal infusion of surfactant during 5 min as an alternative to bolus instillation and to examine whether a PAF receptor antagonist is able to prevent the decrease in blood pressure.
  
  
  METHODS
  Surfactant deficiency was induced in 16 adult rabbits by lung lavages with saline. Six animals received a bolus of a porcine surfactant preparation (Curosurf (CS); 200 mg/kg), labeled with red microspheres to assess pulmonary distribution. In another 5 rabbits, the same amount of labelled CS was instilled by tracheal infusion within 5 min. A third group of 5 animals received 3 mg/kg body weight of the PAF antagonist WEB 2170 before CS bolus instillation.
  
  
  RESULTS
  After CS bolus administration, mean PaO2 increased by 44.7 +/- 8.3 kPa (mean +/- SD) within 2 min and remained at this level. Mean arterial blood pressure dropped transiently by 2.3 +/- 2 kPa within 5 min. Pulmonary distribution of surfactant was even. After infusion, mean PaO2 rose by 22.4 +/- 16.3 kPa within 15 min. Blood pressure dropped by 1.8 +/- 1.1 kPa within 15 min. The distribution was extremely uneven. Blood pressure decreases also occurred after pretreatment with PAF receptor antagonist.
  
  
  CONCLUSIONS
  Rapid tracheal infusion of surfactant results in poorer oxygenation, an inhomogeneous distribution and a similar decrease in blood pressure compared to the bolus instillation method. Blood pressure changes could not be prevented by a PAF receptor-specific antagonist.
authors.affiliation: Department of Neonatology, Virchow Children's Hospital, Humboldt University, Berlin, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Segerer
authors.forename: A
authors.initials: A
authors.lastname: Scheid
authors.forename: M H
authors.initials: MH
authors.lastname: Wagner
authors.forename: M
authors.initials: M
authors.lastname: Lekka
authors.forename: M
authors.initials: M
authors.lastname: Obladen
mesh_terms: D000818:Animals; D001381:Azepines / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects*; D008168:Lung / Q000378:metabolism; D010100:Oxygen / Q000097:blood*; D010972:Platelet Activating Factor / Q000008:administration & dosage* / Q000378:metabolism / Q000494:pharmacology; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D011817:Rabbits; D013501:Surface-Active Agents / Q000008:administration & dosage* / Q000494:pharmacology; D014018:Tissue Distribution; D014132:Trachea; D014230:Triazoles / Q000494:pharmacology
chemical_list: D001381:Azepines; D010972:Platelet Activating Factor; D010975:Platelet Aggregation Inhibitors; D013501:Surface-Active Agents; D014230:Triazoles; C063964:bepafant; D010100:Oxygen