Hyperoncotic enhancement of fetal pulmonary growth after tracheal occlusion: an alveolar and capillary morphometric analysis.
OBJECTIVE
Previous work has shown that intrapulmonary delivery of oncotic agents enhance overall lung growth after late gestational fetal tracheal occlusion (TO). This study was a post hoc analysis aimed at determining whether actual alveolar and capillary hyperplasias are maximized in this setting.


METHODS
Twenty-one near term fetal lambs were evenly divided into 4 groups: group I comprised sham-operated controls; group II had TO alone; and groups III and IV underwent TO and intratracheal infusion of equal amounts of either saline or 25% albumin, respectively. Approximately 2 weeks thereafter, their lungs were examined by detailed alveolar and capillary morphometry before birth. Statistical analysis included analysis of variance and the Bonferroni correction for multiple comparisons (P < .05).


RESULTS
Total alveolar and capillary numbers, as well as total alveolar surface area, were significantly higher in group IV and lower in group I compared with all other groups, with no differences between groups II and III. Alveolar capillary load was normal in all groups.


CONCLUSIONS
Intrapulmonary delivery of concentrated albumin safely enhances short-term alveolar and capillary hyperplasia in a late gestational model of fetal TO. This therapeutic concept may allow for TO to be effective and predictable when performed late in gestation.
Kunisaki
Shaun M
SM
Department of Surgery, Children's Hospital Boston, Boston, MA 02115, USA.
Chang
Robert W
RW
Andreoli
Steven
S
Lewicke
Sara
S
Peña-Peterson
Snow
S
Jennings
Russell W
RW
Fauza
Dario O
DO
D000280:Administration, Inhalation; D000418:Albumins / Q000008:administration & dosage*; D000818:Animals; D002196:Capillaries / Q000187:drug effects; D005260:Female; D047109:Fetal Development / Q000187:drug effects; D005315:Fetal Diseases; D005325:Fetal Organ Maturity / Q000187:drug effects; D006548:Hernia, Diaphragmatic / Q000150:complications; D008026:Ligation; D008168:Lung / Q000098:blood supply / Q000187:drug effects* / Q000503:physiopathology; D008171:Lung Diseases / Q000151:congenital / Q000517:prevention & control; D023421:Models, Animal; D011247:Pregnancy; D011650:Pulmonary Alveoli / Q000187:drug effects* / Q000503:physiopathology; D012756:Sheep; D014132:Trachea / Q000601:surgery*
D000418:Albumins