title: Effect of lung water content, manipulated by intratracheal furosemide, surfactant, or a mixture of both, on compliance and viscoelastic tissue forces in lung-lavaged newborn piglets.
abstract: OBJECTIVE
  To study the impact of lung water content and its reduction by a topically applied diuretic on respiratory and lung tissue mechanics in comparison with surfactant administration in surfactant-deficient newborn piglets with lavage-induced lung injury.
  
  
  METHODS
  Controlled, randomized study.
  
  
  METHODS
  Animal research facility.
  
  
  METHODS
  Newborn piglets. TREATMENT Piglets were surfactant depleted by lung lavage and, after a pretreatment period, randomly treated with intratracheal furosemide, furosemide and surfactant, or with surfactant alone.
  
  
  RESULTS
  Dynamic compliance (C(DYN)), static compliance (C(ST)), stress-adaptation pressures (P(DIFF)) and post mortem lung water content were determined. Static compliance in the furosemide-surfactant group was not significantly higher than in the surfactant group. At the end of the study, C(ST) did not differ between the three groups because C(ST) in the furosemide group had increased to values similar to those of the surfactant-containing treatment groups: C(ST) F+S: 0.73 +/- 0.2 mL/cm H2O/kg body weight (BW); C(ST) S: 0.61 +/- 0.11 mL/cm H2O/kg BW; and C(ST) F: 0.60 +/- 0.19 mL/cm H2O/kg BW). Compliance was inversely and P(DIFF) was directly correlated to lung water (LW) content (C(ST) vs. LW: r2 = .59, p = .001; C(DYN) vs. LW: r2 = .49, p = .006; P(DIFF) vs. LW: r2 = .37, p = .059), independent of the type of treatment. Changes in C(ST) and C(DYN) were inversely related to changes in P(DIFF). Intrapulmonary furosemide was more rapidly absorbed when administered to the surfactant-depleted lung alone compared with the mixture with surfactant, and intrapulmonary furosemide had a rapid systemic effect.
  
  
  CONCLUSIONS
  Although the combination of surfactant with a diuretic failed to increase respiratory compliance to a significantly larger extent than surfactant alone, furosemide at the end of the study increased respiratory compliance to a level similar to surfactant-containing treatments. Lung water content and, to a lesser extent, the absence or presence of surfactant appeared to determine lung mechanics, and its impact on lung mechanics was similar to surfactant administration.
authors.affiliation: University Children's Hospital, Dr. v. Haunersches Kinderspital, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Flemmer
authors.forename: G
authors.initials: G
authors.lastname: Simbruner
authors.forename: S
authors.initials: S
authors.lastname: Muenzer
authors.forename: H
authors.initials: H
authors.lastname: Proquitté
authors.forename: C
authors.initials: C
authors.lastname: Haberl
authors.forename: T
authors.initials: T
authors.lastname: Nicolai
authors.forename: R
authors.initials: R
authors.lastname: Leiderer
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D004232:Diuretics / Q000032:analysis / Q000494:pharmacology*; D004548:Elasticity; D015633:Extravascular Lung Water; D005665:Furosemide / Q000032:analysis / Q000494:pharmacology*; D008170:Lung Compliance / Q000187:drug effects*; D011663:Pulmonary Surfactants / Q000494:pharmacology*; D012119:Respiration; D013552:Swine; D007507:Therapeutic Irrigation; D014783:Viscosity
chemical_list: D004232:Diuretics; D011663:Pulmonary Surfactants; D005665:Furosemide