Document Detail


Exogenous surfactant reduces ventilator-induced decompartmentalization of tumor necrosis factor alpha in absence of positive end-expiratory pressure.
MedLine Citation:
PMID:  12185437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of pretreatment with exogenous surfactant on ventilator-induced decompartmentalization of TNF-alpha. DESIGN AND SETTING: Prospective, randomized, animal study in the experimental laboratory of a university. SUBJECTS AND INTERVENTIONS: Male Sprague-Dawley rats (n=102) received lipopolysaccharide either intratracheally or intraperitoneally to stimulate TNF-alpha production; one-half of the animals were pretreated with surfactant. Animals were ventilated for 20 min with a peak inspiratory pressure/positive end-expiratory pressure (PEEP) ratio of either 45/0 or 45/10 (frequency 30 bpm, I/E ratio 1:2, FIO(2)=1). MEASUREMENTS AND RESULTS: Blood gas tension and arterial pressures were recorded 1, 10, and 20 min after the start of mechanical ventilation. After the animals were killed pressure-volume curves were recorded, and bronchoalveolar lavage was performed for assessment of protein content and the small/large surfactant aggregate ratio. TNF-alpha was determined in serum and bronchoalveolar lavage. Pretreatment with surfactant decreased decompartmentalization of TNF-alpha during 45/0 ventilation. Addition of a PEEP level of 10 cm H(2)O reduced decompartmentalization even further. In addition, surfactant prevented deterioration in oxygenation and decreased accumulation of protein in the bronchoalveolar lavage in the zero-PEEP group. CONCLUSIONS: An excess of active surfactant decreases transfer of cytokines across the alveolar-capillary membrane similar to PEEP. The combination of PEEP and surfactant reduces decompartmentalization of TNF-alpha even further.
Authors:
Jack J Haitsma; Stefan Uhlig; Ulrike Lachmann; Serge J Verbrugge; Davey L H Poelma; Burkhard Lachmann
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2002-07-13
Journal Detail:
Title:  Intensive care medicine     Volume:  28     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-19     Completed Date:  2002-12-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1131-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Animals
Enzyme-Linked Immunosorbent Assay
Germany
Lipopolysaccharides / administration & dosage
Male
Positive-Pressure Respiration*
Pulmonary Surfactants / pharmacology*
Rats
Rats, Sprague-Dawley
Tumor Necrosis Factor-alpha / biosynthesis,  secretion*
Chemical
Reg. No./Substance:
0/Lipopolysaccharides; 0/Pulmonary Surfactants; 0/Tumor Necrosis Factor-alpha

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