Document Detail

Comparison of exogenous surfactant and positive end-expiratory pressure therapies in a model of human breast milk-induced acute lung injury in rabbits.
MedLine Citation:
PMID:  10844837     Owner:  NLM     Status:  MEDLINE    
To evaluate surfactant and positive end-expiratory pressure (PEEP) as potential therapies for the acute lung injury after tracheal instillation of 0.8 ml kg-1 human breast milk (HBM) acidified to pH 1.8, adult white rabbits were anaesthetized, tracheostomized, ventilated and randomized to (six rabbits per treatment): (i) no treatment after HBM (control); (ii) exogenous Bovine surfactant (100 mg kg-1) 1 h after HBM; (iii) PEEP-pre (0.5 kPa PEEP) before and after HBM; or (iv) PEEP-post (0.5 kPa PEEP) after HBM. A fifth group of six rabbits received no tracheal instillate (no aspirate). The alveolar to arterial oxygen tension gradient (A-aDO2) and dynamic compliance were measured pre-injury and hourly for 4 h. At post-mortem, the lungs were examined histologically. A-aDO2 in all four HBM-injured groups increased to a maximum at 1 h post-injury; A-aDO2 then returned towards the baseline in the surfactant and PEEP-post groups, but remained increased in the PEEP-pre and control groups. Dynamic compliance decreased in all four HBM-injured groups. A-aDO2 and compliance were unchanged in the no aspirate group. Bronchoalveolar architecture after surfactant therapy was normal. We conclude that surfactant is a more effective therapy for HBM-induced lung injury than either 0.5 kPa PEEP-post or PEEP-pre injury.
C Chin; B O'Hare; J Lerman; J Endo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  84     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-06-14     Completed Date:  2000-06-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  600-7     Citation Subset:  IM    
Department of Anaesthesia, Hospital For Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Administration, Inhalation
Lung / pathology
Milk, Human*
Pneumonia, Aspiration / etiology,  pathology,  therapy*
Positive-Pressure Respiration*
Pulmonary Surfactants / therapeutic use*
Specific Pathogen-Free Organisms
Treatment Outcome
Reg. No./Substance:
0/Pulmonary Surfactants

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