Document Detail


Liquid assisted ventilation: an alternative ventilatory strategy for acute meconium aspiration injury.
MedLine Citation:
PMID:  8726157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Evidence of surfactant inactivation by meconium has led to the use of exogenous surfactant therapy in the management of meconium aspiration syndrome (MAS). Liquid assisted ventilation has been shown to improve the cardiopulmonary function in lungs with high surface tension. We compared exogenous surfactant therapy with liquid assisted ventilation in the management of experimental acute meconium aspiration injury. Thirty-two newborn lambs were ventilated at peak inspiratory pressures of 13-16 cm H2O, positive end expiratory pressure of 3-4 cm H2O, fractional inspired oxygen concentration (FiO2) of 1.0, and a respiratory frequency range between 30 and 35 breaths/min. Baseline arterial blood gases, pulmonary function, and arterial blood pressure measurements were taken. All lambs were given 2-3 ml/kg of an unfiltered 25% meconium solution. Lambs were then randomized into either gas-ventilated meconium control, or one of three treatment groups: 1) surfactant; 2) partial liquid ventilation (PLV); or 3) total liquid ventilation (TLV) for 4 hours after meconium injury. All treated groups demonstrated a significant increase in arterial oxygenation (P < 0.05); surfactant and PLV-treated lambs demonstrated significantly decreased arterial PCO2 (P < 0.05). Compliance in all groups increased compared with injury values; compliance of the TLV group increased more than in all other treatment groups (P < 0.05). In addition, lung histology of the TLV group demonstrated clear, intact alveolar epithelium and homogeneously expanded alveoli, while no such improvement was evident in the other groups. These data suggest roles for both exogenous surfactant therapy and liquid assisted ventilation techniques in the management of MAS.
Authors:
R Foust; N N Tran; C Cox; T F Miller; J S Greenspan; M R Wolfson; T H Shaffer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  21     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-11-06     Completed Date:  1996-11-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  316-22     Citation Subset:  IM    
Affiliation:
Department of Physiology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Disease Models, Animal
Female
Humans
Infant, Newborn
Lung / pathology
Lung Compliance / physiology
Lung Volume Measurements
Male
Meconium Aspiration Syndrome / pathology,  physiopathology,  therapy*
Oxygen / blood
Pulmonary Surfactants / administration & dosage*
Respiration, Artificial*
Sheep
Grant Support
ID/Acronym/Agency:
R29HD26341/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Pulmonary Surfactants; 7782-44-7/Oxygen

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


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