Effects of therapeutic bronchoalveolar lavage and partial liquid ventilation on meconium-aspirated newborn piglets.
OBJECTIVE
To investigate the therapeutic effects of bronchoalveolar lavage (BAL) with either diluted surfactant (SBAL) or perfluorochemical liquid (PBAL), followed by either conventional mechanical ventilation (CMV) or partial liquid ventilation (PLV), on lung injury and proinflammatory cytokine production induced by meconium aspiration in newborn piglets.


METHODS
A prospective, randomized, experimental study.


METHODS
An animal research laboratory at a medical center.


METHODS
Anesthetized and mechanically ventilated newborn piglets (n = 27).


METHODS
The animals were instilled with 3-5 mL/kg 25% human meconium via an endotracheal tube to induce meconium aspiration syndrome (MAS). After stabilization, animals were randomly assigned to either CMV group (no BAL) or one of the treatment groups (SBAL-CMV, SBAL-PLV, PBAL-CMV, and PBAL-PLV).


RESULTS
Cardiopulmonary variables were monitored, and interleukin-1beta and interleukin-6 content of the serum and lung tissue was measured. The animals without any treatment (CMV group) displayed the worst outcome; the animals in the PBAL-PLV group had the best gas exchange, lung compliance, and least pulmonary damage; and the SBAL-CMV, PBAL-CMV, and SBAL-PLV groups had intermediate effects. The serum interleukin-1beta concentration of the CMV group was significantly higher than all other groups over time (p < .05), and interleukin-6 concentration was significantly higher than the PBAL-PLV group (p < .05). The tissue interleukin-1beta and interleukin-6 contents were also highest in the CMV group and lowest in the PBAL-PLV group.


CONCLUSIONS
Initial therapeutic BAL and therapeutic BAL followed by PLV with the same perfluorochemical liquid provided significant therapeutic effects in treating an animal model with severe MAS and therefore warrant consideration in cases that are intractable to other therapies.
School of Medicine, National Yang-Ming University, Taipei Taiwan. mjjeng@vghtpe.gov.tw
Mei-Jy
MJ
Jeng
Wen-Jue
WJ
Soong
Yu-Sheng
YS
Lee
Hua-Lun
HL
Chang
Chung-Min
CM
Shen
Chua-Ho
CH
Wang
Shyh-Sheng
SS
Yang
Betau
B
Hwang
D000818:Animals; D000831:Animals, Newborn; D018893:Bronchoalveolar Lavage; D003131:Combined Modality Therapy; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D021061:Liquid Ventilation; D008471:Meconium Aspiration Syndrome / Q000628:therapy*; D013552:Swine
D005466:Fluorocarbons; C003073:perfluoromethylcyclohexane