Document Detail


Exogenous surfactant and partial liquid ventilation: physiologic and pathologic effects.
MedLine Citation:
PMID:  9351603     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared the effects of surfactant and partial liquid ventilation (PLV), and the impact of administration order, on oxygenation, respiratory system compliance (Crs), hemodynamics, and lung pathology in an animal lung injury model. We studied four groups: surfactant alone (S; n = 8); partial liquid ventilation alone (PLV-only; n = 8); surfactant followed by partial liquid ventilation (S-PLV; n = 8); and partial liquid ventilation-followed by surfactant (PLV-S; n = 8). Following treatments, all animals had improved oxygenation index (OI) and Crs. Animals in PLV groups showed continued improvement over 2 h (% change OI: PLV-S -83% versus S -47%, p < 0.05; % change Crs: S-PLV 73% versus S 13%, p < 0.05). We also saw administration-order effects: surfactant before PLV improved Crs (0.92 ml/cm H2O after surfactant versus 1.13 ml/cm H2O after PLV, p < 0.02) without changing OI, whereas surfactant after PLV did not change Crs and OI increased (5.01 after PLV versus 8.92 after surfactant, p < 0.03). Hemodynamics were not different between groups. Pathologic analysis demonstrated decreased lung injury in dependent lobes of all PLV-treated animals, and in all lobes of S-PLV animals, when compared with the lobes of the S animals (p < 0.05). We conclude that surfactant therapy in combination with PLV improved oxygenation, respiratory system mechanics, and lung pathology to a greater degree than surfactant therapy alone. Administration order affected initial physiologic response and ultimate pathology: surfactant given before PLV produced the greatest improvements in pathologic outcomes.
Authors:
J D Mrozek; K M Smith; D R Bing; P A Meyers; S C Simonton; J E Connett; M C Mammel
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  156     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-11-18     Completed Date:  1997-11-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1058-65     Citation Subset:  AIM; IM    
Affiliation:
Infant Pulmonary Research Center, Children's Health Care-St. Paul, Minnesota 55102, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Blood Gas Analysis
Compliance / drug effects
Disease Models, Animal
Fluorocarbons / pharmacology*
Hemodynamics / drug effects
Lung / drug effects*,  physiopathology
Lung Diseases / drug therapy,  pathology,  physiopathology*
Lung Injury
Pulmonary Gas Exchange / drug effects
Pulmonary Surfactants / pharmacology*
Random Allocation
Respiratory Mechanics / drug effects*
Swine
Chemical
Reg. No./Substance:
0/Fluorocarbons; 0/Pulmonary Surfactants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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