Persurf, a new method to improve surfactant delivery: a study in surfactant depleted rats.
OBJECTIVE
Exogenous surfactant is not very effective in adults with ARDS, since surfactant does not reach atelectatic alveoli. Perfluorocarbons (PFC) can recruit atelectatic areas but do not replace impaired endogenous surfactant. A surfactant-PFC-mixture could combine benefits of both therapies. The aim of the proof-of-principal-study was to produce a PFC-in-surfactant emulsion (Persurf) and to test in surfactant depleted Wistar rats whether Persurf achieves I.) a more homogenous pulmonary distribution and II.) a more homogenous recruitment of alveoli when compared with surfactant or PFC alone.


METHODS
Three different PFC were mixed with surfactant and phospholipid concentration in the emulsion was measured. After surfactant depletion, animals either received 30 ml/kg of PF5080, 100 mg/kg of stained (green dye) Curosurf™ or 30 ml/kg of Persurf. Lungs were fixated after 1 hour of ventilation and alveolar aeration and surfactant distribution was estimated by a stereological approach.


RESULTS
Persurf contained 3 mg/ml phospholipids and was stable for more than 48 hours. Persurf-administration improved oxygenation. Histological evaluation revealed a more homogenous surfactant distribution and alveolar inflation when compared with surfactant treated animals.


CONCLUSIONS
In surfactant depleted rats administration of PFC-in-surfactant emulsion leads to a more homogenous distribution and aeration of the lung than surfactant alone.
Department for Neonatology and Pediatric Intensive Care Medicine, Klinik für Kinderheilkunde, Universitätsklinikum Carl Gustav Carus, Medizinische Fakultät der Technischen Universität Dresden, Dresden, Germany.
Wolfram
W
Burkhardt
Stephan
S
Kraft
Matthias
M
Ochs
Hans
H
Proquitté
Lars
L
Mense
Mario
M
Rüdiger
D000818:Animals; D001784:Blood Gas Analysis; D016503:Drug Delivery Systems / Q000379:methods*; D004655:Emulsions; D005466:Fluorocarbons / Q000737:chemistry*; D008168:Lung / Q000187:drug effects / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D010743:Phospholipids / Q000032:analysis; D011663:Pulmonary Surfactants / Q000008:administration & dosage* / Q000494:pharmacology*; D051381:Rats; D017208:Rats, Wistar
D004655:Emulsions; D005466:Fluorocarbons; D010743:Phospholipids; D011663:Pulmonary Surfactants