Hyperoncotic enhancement of pulmonary growth after fetal tracheal occlusion: a comparison between dextran and albumin.
OBJECTIVE
This study was aimed at comparing albumin and dextran as intrapulmonary hyperoncotic enhancers of fetal lung growth after tracheal occlusion.


METHODS
Fetal lambs (n = 27) were divided proportionally into 5 groups: group I consisted of sham-operated controls; group II underwent tracheal occlusion (TO); groups III, IV, and V underwent TO and intratracheal infusion of 60 mL of either saline, 6% dextran-70, or 25% albumin, respectively. Multiple fetal lung analyses were performed near term. Statistical analysis was by 1-way analysis of variance (ANOVA) and post-hoc analyses by the Bonferroni correction for multiple comparisons (P <.05).


RESULTS
The lung volume-to-body weight ratio was significantly higher in groups IV and V than in all other groups with no differences between groups II and III, nor between groups IV and V. Airspace fraction was not significantly different among the groups, nor was there any evidence of alveolar cellular damage. Type-II pneumocyte density was higher in group I than in groups II, IV, and V, with no differences among the latter 3 groups. Lung liquid biochemical profile was normal in all groups.


CONCLUSIONS
Albumin is as effective as dextran as an intrapulmonary hyperoncotic booster of lung growth acceleration after fetal tracheal occlusion, with no lasting effects on its fetal lung liquid levels. As a naturally occurring oncotic agent, albumin may be a safer option in the clinical application of this therapeutic concept.
Chang
Robert
R
Department of Surgery, Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Komura
Makoto
M
Andreoli
Steven
S
Klingenberg
Markus
M
Jennings
Russell
R
Wilson
Jay
J
Fauza
Dario
D
D000418:Albumins / Q000494:pharmacology* / Q000627:therapeutic use; D000704:Analysis of Variance; D000818:Animals; D003911:Dextrans / Q000494:pharmacology* / Q000627:therapeutic use; D005314:Embryonic and Fetal Development / Q000187:drug effects*; D005260:Female; D005315:Fetal Diseases / Q000628:therapy; D006548:Hernia, Diaphragmatic / Q000196:embryology* / Q000401:mortality / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006874:Hydrostatic Pressure; D008099:Liver / Q000002:abnormalities; D008168:Lung / Q000187:drug effects / Q000196:embryology*; D008176:Lung Volume Measurements; D011247:Pregnancy; D011248:Pregnancy Complications; D011296:Prenatal Diagnosis; D012756:Sheep; D015996:Survival Rate; D014132:Trachea / Q000601:surgery*
D000418:Albumins; D003911:Dextrans