Document Detail

Effects of ventilation strategies on the efficacy of exogenous surfactant therapy in a rabbit model of acute lung injury.
MedLine Citation:
PMID:  9445293     Owner:  NLM     Status:  MEDLINE    
We evaluated the effects of various ventilation strategies on the efficacy of exogenous surfactant therapy in lung-injured adult rabbits. Lung injury was induced by repetitive whole-lung saline lavage followed by mechanical ventilation. Three hours after the final lavage, 100 mg lipid/kg bovine lipid extract surfactant was instilled. After confirmation of similar responses to exogenous surfactant, animals were then randomized to one of four ventilation groups; (1) Normal tidal volume (VT) (5 cm H2O): VT = 10 ml/kg, respiratory rate (RR) = 30/min, positive end-expiratory pressure (PEEP) = 5 cm H2O; (2) Normal VT (9 cm H2O): VT = 10 ml/kg, RR = 30/min, PEEP = 9 cm H2O; (3) Low VT (5 cm H2O): VT = 5 ml/kg, RR = 60/min, PEEP = 5 cm H2O; (4) Low VT (9 cm H2O): VT = 5 ml/kg, RR = 60/min, PEEP = 9 cm H2O. Animals were ventilated for an additional 3 h and then killed, and lung lavage fluid was analyzed. Animals ventilated with the low-VT modes (Low VT [5 cm H2O] and Low VT [9 cm H2O]) had higher PaO2 values (430 +/- 7 mm Hg and 425 +/- 18 mm Hg versus 328 +/- 13 mm Hg) and higher percentages of surfactant in large aggregate forms (83 +/- 2% and 82 +/- 2% versus 67 +/- 4%) at 3 h after treatment than did the Normal VT (5 cm H2O) group (p < 0.05). Increasing the PEEP level was beneficial for a short period after surfactant administration to maintain oxygenation, but did not affect exogenous surfactant aggregate conversion. We speculate that ventilation strategies resulting in low exogenous surfactant aggregate conversion will result in superior physiologic responses to exogenous surfactant.
Y Ito; S E Manwell; C L Kerr; R A Veldhuizen; L J Yao; D Bjarneson; L A McCaig; A J Bartlett; J F Lewis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  157     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-02-05     Completed Date:  1998-02-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  149-55     Citation Subset:  AIM; IM    
Department of Physiology, Lawson Research Institute, St. Joseph's Health Centre, University of Western Ontario, London, Canada.
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MeSH Terms
Blood Gas Analysis
Bronchoalveolar Lavage Fluid / chemistry
Disease Models, Animal*
Drug Evaluation, Preclinical
Positive-Pressure Respiration / methods*
Pulmonary Surfactants / administration & dosage,  metabolism*
Random Allocation
Respiratory Distress Syndrome, Adult / chemically induced,  metabolism,  therapy*
Sodium Chloride
Tidal Volume
Reg. No./Substance:
0/Pulmonary Surfactants; 7647-14-5/Sodium Chloride

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