title: Surfactant treatment for ventilation-induced lung injury in rats: effects on lung compliance and cytokines.
abstract: The objective of this study was to determine if exogenous surfactant therapy could prevent the harmful effects of ventilation at high tidal volumes without positive end-expiratory pressure (PEEP). Rats were randomized to either a nontreated control group (8 mL/kg 4 cm H2O PEEP), a nontreated injuriously ventilated group (20 mL/kg 0 cm H2O PEEP) or a treatment group of either 50 mg/kg, 50 mg/kg + 5% surfactant-associated protein A, 100 mg/kg exogenous surfactant followed by injurious ventilation. Isolated lungs from animals in all 5 groups were ventilated in a humidified box at 37 degrees C for 2 hours. Pressure-volume curves and light microscopy showed that surfactant treatment reduced the ventilation-induced lung injury (VILI). Inflammatory cytokines (tumor necrosis factor-alpha [TNFalpha], interleukin [IL]-1beta, and IL-6) in the lavage were significantly higher in injuriously ventilated lungs compared to the control group. However the 3 treatment groups had cytokine concentrations that were similar to the injuriously ventilated group. We conclude that surfactant treatment is beneficial in preventing VILI; however, it does not prevent the release of inrflammatory cytokines during mechanical ventilation.
authors.affiliation: Department of Medicine, Lawson Health Research Institute, University of Western Ontario, London, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Welk
authors.forename: J L
authors.initials: JL
authors.lastname: Malloy
authors.forename: M
authors.initials: M
authors.lastname: Joseph
authors.forename: L J
authors.initials: LJ
authors.lastname: Yao
authors.forename: A W
authors.initials: AW
authors.lastname: Veldhuizen
mesh_terms: D000818:Animals; D016207:Cytokines / Q000378:metabolism*; D007375:Interleukin-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008168:Lung / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008170:Lung Compliance / Q000187:drug effects; D008171:Lung Diseases / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D008297:Male; D011510:Proteolipids / Q000494:pharmacology*; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012121:Respiration, Artificial / Q000009:adverse effects*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D011510:Proteolipids; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants; D014409:Tumor Necrosis Factor-alpha