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Surfactant increases the uniformity of lung aeration at birth in ventilated preterm rabbits.
MedLine Citation:
PMID:  21451432     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Surfactant deficiency is a major cause of respiratory failure in newborns. We have investigated the roles of surfactant and positive end-expiratory pressure (PEEP) in the development of a functional residual capacity (FRC) and the distribution of ventilation at birth. Preterm rabbit pups (28d GA) were delivered and received either saline or surfactant and then ventilated with (3PEEP) or without (0PEEP) 3cmH2O PEEP (groups: saline/0PEEP, surfactant/0PEEP, saline/3PEEP, surfactant/3PEEP). Lung gas volumes were measured using plethysmography and the uniformity of ventilation was analyzed using phase contrast (PC) X-ray imaging. Surfactant/0PEEP pups had greater FRCs and the lungs were more uniformly ventilated than saline/0PEEP pups; FRC at inflation 19-21 was 2.46 ± 0.52ml/kg vs. 0.91 ± 0.95ml/kg (p<0.05). Saline/3PEEP pups developed a FRC of 7.54 ± 1.68ml/kg at breath 19-21 (p<0.05), but the distribution of ventilation was initially non-uniform. Surfactant/3PEEP pups had an FRC of 8.50 ± 0.80ml/kg (at inflation 19-21) and the distribution of ventilation was more uniform than with saline/3PEEP (p<0.05). In ventilated preterm newborn rabbits, PEEP has a greater effect on FRC than surfactant, although the two are additive. Surfactant, administered at birth, markedly improved the uniformity of ventilation irrespective of whether PEEP was applied. ABBREVIATIONS::
Authors:
Melissa L Siew; Arjan B Te Pas; Megan J Wallace; Marcus J Kitchen; Muhammad Islam; Robert A Lewis; Andreas Fouras; Colin J Morley; Peter G Davis; Naoto Yagi; Kentaro Uesugi; Stuart B Hooper
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-29
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Monash Institute of Medical Research [M.L.S., M.J.W., S.B.H.], School of Physics [M.J.K., M.I.], Monash Centre for Synchrotron Science [R.A.L.], Division of Biological Engineering [A.F.], Monash University, Melbourne, VIC 3800, Australia; Department of Pediatrics [A.B.P], Leiden University Medical Centre 2300 RC Leiden, the Netherlands; Neonatal Research, Royal Women's Hospital [C.J.M., P.G.D.], Parkville, Victoria 3052, Australia; SPring-8/JASRI [N.Y., K.U.], Sayo, Hyogo 679-5198, Japan.
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