Mechanism of acute lung injury caused by inhalation of fabric protector and the effect of surfactant replacement.
OBJECTIVE
To evaluate the role of surfactant in the mechanism and treatment of acute lung injury caused by inhalation of fabric protector.


METHODS
Prospective, randomized study.


METHODS
University laboratory.


METHODS
In vitro experiment: a porcine surfactant suspension (10 mg.ml-1) was exposed to a fabric protector aerosolized with an ultrasonic nebulizer for 1 min. Minimum surface tension (gamma min) was sequentially measured using pulsating bubble equipment. Animal experiment: 14 adult rats were anesthetized with pentobarbital and mechanically ventilated with pure oxygen. Then, all rats inhaled fabric protector aerosolized with the nebulizer for five breaths. Three hours after inhalation, the rats were randomly assigned to two groups: a surfactant group (n = 7), in which surfactant (100 mg.kg-1) was replaced, and a control group (n = 7), in which no substance was given.


RESULTS
In vitro experiment: exposure to fabric protector aerosol increased the mean gamma min of the surfactant from 1.7 to 19.2 mN.m-1 (n = 5, p < 0.05). Animal experiment; the mean partial pressure of oxygen in arterial blood (PaO2) in all rats decreased from 62.8 to 17.1 kPa at 3 h after inhalation. The PaO2 in the surfactant group increased to 49.8 +/- 11.1 (SD) kPa at 30 min after surfactant replacement (p < 0.05), while the PaO2 in the control group remained below 20 kPa.


CONCLUSIONS
Impairment of surfactant is a factor involved in the development of acute lung injury caused by inhalation of fabric protector. Surfactant replacement may be therapeutic for such injuries.
Tashiro
K
K
Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, School of Medicine, Kanazawa University, Japan. tashirk@med.kanazawa-u.ac.jp
Matsumoto
Y
Y
Nishizuka
K
K
Shibata
K
K
Yamamoto
K
K
Yamashita
M
M
Kobayashi
T
T
D000085:Acetates / Q000009:adverse effects*; D000473:Alkanes / Q000009:adverse effects*; D000818:Animals; D019570:Inhalation Exposure / Q000009:adverse effects*; D008168:Lung / Q000187:drug effects*; D055370:Lung Injury; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D011897:Random Allocation; D051381:Rats; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000188:drug therapy*; D012997:Solvents / Q000009:adverse effects*
D000085:Acetates; D000473:Alkanes; D011663:Pulmonary Surfactants; D012997:Solvents; C007650:ethyl acetate; C004544:naphtha