[Treatment of acute lung injury due to sea water aspiration in dogs by early massive bronchoalveolar lavage: an experimental study].
OBJECTIVE
To investigate the therapeutic effects of massive bronchoalveolar lavage at early stage of acute lung injury induced by sea water aspiration.


METHODS
Twelve mongrel dogs were subjected to sea water infusion of the entire lungs and were subsequently randomized into 2 groups. The dogs in group A received intravenous saline transfusion 24 h after injury, while those in group B underwent bronchoscopic lavage of injured lungs with 450 ml 0.45% saline 15 min after injury. Unassisted breathing was maintained in both groups, and the gas exchange function of the bilateral lungs and the levels of lactate dehydrogenase, alkaline phosphatase in the bronchoalveolar fluid were observed, with the hemodynamics indices monitored continuously. The lungs of the dogs were finally removed for morphological study under both light and electron microscopes, and the water content and wet- to dry-weight ratio of the lung tissues were determined.


RESULTS
A total lavage volume of approximately 30 ml/kg x b.w. was used, and the liquid volume remaining in the lungs after operation ranged from 80 to 120 ml. All the dogs manifested significant declination in pulmonary function after the drowning. PaO2 in group B decreased significantly soon after the lavage but then increased gradually to a higher levels than group A. The dogs in group B had smaller lung water content and lower levels of lactate dehydrogenase and alkaline phosphatase in the bronchoalveolar fluid, showing improved oxygenation in comparison with group A. The inflammatory reaction and edema in lungs were also markedly alleviated in group B.


CONCLUSIONS
Treatment with massive lung lavage in early stage after sea water aspiration can effectively protect the lung tissues from damage and alleviate the inflammatory reaction and pulmonary edema, helping to improve the lung function.
Huang
Yi-ran
YR
Department of Anesthesiology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Gu
Miao-ning
MN
Xiao
Jin-fang
JF
Zhou
Wei
W
Fu
Wei-jun
WJ
Chen
Ye-ming
YM
D000818:Animals; D018893:Bronchoalveolar Lavage / Q000379:methods*; D004285:Dogs; D005260:Female; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D010100:Oxygen / Q000097:blood; D011659:Pulmonary Gas Exchange; D011859:Radiography; D012119:Respiration; D012128:Respiratory Distress Syndrome / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D012623:Seawater
D010100:Oxygen