Document Detail

Intratracheal surfactant administration preserves airway compliance during lung reperfusion.
MedLine Citation:
PMID:  8957361     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Decreased airway compliance after lung transplantation has been observed with severe ischemia-reperfusion injury. Further, it has been shown that the surfactant system is impaired after lung preservation and reperfusion. We hypothesized that surfactant replacement after allograft storage could preserve airway compliance during reperfusion. METHODS: Rabbit lungs were harvested after flush with 50 mL/kg of cold saline solution. Immediate control lungs were studied with an isolated ventilation/perfusion apparatus using venous rabbit blood recirculated at 40 mL/min, room-air ventilation at 20 breaths/min, and constant airway pressure (n = 8). Twenty-four-hour control lungs were preserved at 4 degrees C for 24 hours and then similarly studied (n = 7). Surfactant lungs underwent similar harvest and preservation for 24 hours, but received 1.5 mL/kg of intratracheal surfactant 5 minutes before reperfusion (n = 10). Airway pressure and flow were recorded continuously during 30 minutes of reperfusion. Tidal volume and airway compliance were calculated at 30 minutes. RESULTS: Tidal volume was 33.67 +/- 0.57, 15.75 +/- 5.72, and 29.83 +/- 1.07 mL in the immediate control, 24-hour control, and surfactant groups, respectively (p = 0.004, surfactant versus 24-hour control). Airway compliance was 1.94 +/- 0.27, 0.70 +/- 0.09, and 1.46 +/- 0.10 mL/mm Hg in the immediate control, 24-hour control, and surfactant groups, respectively (p = 0.002, surfactant versus 24-hour control). CONCLUSIONS: We conclude that surfactant administration before reperfusion after 24 hours of cold storage preserves tidal volume and airway compliance in the isolated ventilated/perfused rabbit model of lung reperfusion injury.
S A Buchanan; M C Mauney; V I Parekh; N F DeLima; O A Binns; J T Cope; K S Shockey; C G Tribble; I L Kron
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  62     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-09     Completed Date:  1997-01-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1617-21     Citation Subset:  AIM; IM    
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
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MeSH Terms
Lung / blood supply*,  pathology
Lung Compliance*
Lung Transplantation
Organ Preservation
Organ Size
Pulmonary Surfactants / administration & dosage*
Reperfusion Injury / pathology,  prevention & control*
Tidal Volume
Vascular Resistance
Ventilation-Perfusion Ratio
Grant Support
Reg. No./Substance:
0/Pulmonary Surfactants

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