title: Comparative effects of bronchoalveolar lavage with saline, surfactant, or perfluorocarbon in experimental meconium aspiration syndrome.
abstract: OBJECTIVE
  Today, in meconium aspiration syndrome, treatment focuses on bronchoalveolar lavage, because it removes meconium and proinflammatory factors from airways. This technique might be more effective if different solutions were used such as saline solution, a protein-free surfactant, or a perfluorocarbon, because these would be less inhibited by meconium proteins.
  
  
  METHODS
  Pulmonary physiology research unit, Cruces Hospital.
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  We studied 24 lambs (<6 days) on mechanical ventilation for 180 mins. Catheters were placed and femoral and pulmonary arteries pressures registered (systemic and pulmonary arterial pressures).
  
  
  METHODS
  Lambs were instilled with 20% meconium (3-5 mL/Kg) and were randomly assigned to one of the following groups (n = 6): control: only continuous mechanical ventilation; saline bronchoalveolar lavage: bronchoalveolar lavage with 30 mL/kg of saline solution; dilute surfactant bronchoalveolar lavage: bronchoalveolar lavage with 32 mL/kg of diluted surfactant (lucinactant, 10 mg/mL); or perfluorocarbon bronchoalveolar lavage: bronchoalveolar lavage with 30 mL/kg of perfluorocarbon.
  
  
  RESULTS
  Blood gases, cardiovascular parameters, and pulmonary mechanics were assessed. Meconium instillation produced severe hypoxia, hypercapnia, acidosis, and pulmonary hypertension with impairment of pulmonary mechanics (p < .05). Lung lavage with dilute surfactant resulted in the resolution of pulmonary hypertension as well as better gas exchange and pulmonary mechanics than the control group (p < .05). Bronchoalveolar lavage with perfluorocarbon produced a transient improvement in gas exchange and ventilatory indices in comparison with control and saline bronchoalveolar lavage groups.
  
  
  CONCLUSIONS
  In lambs with meconium aspiration syndrome, bronchoalveolar lavage with diluted lucinactant is an effective therapy producing significant improvements in gas exchange, pulmonary hypertension, and pulmonary mechanics. In addition, bronchoalveolar lavage with perfluorocarbon appears to confer some advantages over lavage with equal volumes of saline or no lavage.
authors.affiliation: Pulmonary Physiology Research Unit, Hospital of Cruces, Barakaldo, Bizkaia, Spain. macarmen.reysantano@osakidetza.net
authors.forename: Carmen
authors.initials: C
authors.lastname: Rey-Santano
authors.forename: Victoria E
authors.initials: VE
authors.lastname: Mielgo
authors.forename: Elena
authors.initials: E
authors.lastname: Gastiasoro
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Alvarez-Diaz
authors.forename: Hector
authors.initials: H
authors.lastname: Lafuente
authors.forename: Adolfo
authors.initials: A
authors.lastname: Valls-i-Soler
authors.forename: Xabier
authors.initials: X
authors.lastname: Murgia
mesh_terms: D000818:Animals; D018893:Bronchoalveolar Lavage / Q000379:methods*; D004195:Disease Models, Animal; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000627:therapeutic use*; D005466:Fluorocarbons / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000628:therapy*; D010715:Phosphatidylglycerols / Q000627:therapeutic use*; D011506:Proteins / Q000627:therapeutic use*; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D011897:Random Allocation; D012121:Respiration, Artificial; D012756:Sheep; D012965:Sodium Chloride / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D005233:Fatty Alcohols; D005466:Fluorocarbons; D010715:Phosphatidylglycerols; D011506:Proteins; D011663:Pulmonary Surfactants; C502722:lucinactant; D012965:Sodium Chloride