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Titolo:
Alveolar recruitment promotes homogeneous surfactant distribution in a piglet model of lung injury
Autore:
Krause, MF; Jakel, C; Haberstroh, J; Schulte-Monting, J; Leititis, JU; Orlowska-Volk, M;
Indirizzi:
Univ Freiburg, Sch Med, Dept Pediat, D-79106 Freiburg, Germany Univ Freiburg Freiburg Germany D-79106 Pediat, D-79106 Freiburg, Germany Univ Freiburg, Sch Med, Dept Surg, D-79106 Freiburg, Germany Univ Freiburg Freiburg Germany D-79106 t Surg, D-79106 Freiburg, Germany Univ Freiburg, Sch Med, Dept Med Biometry & Stat, D-79106 Freiburg, Germany Univ Freiburg Freiburg Germany D-79106 & Stat, D-79106 Freiburg, Germany Univ Freiburg, Sch Med, Dept Pathol, D-79106 Freiburg, Germany Univ Freiburg Freiburg Germany D-79106 Pathol, D-79106 Freiburg, Germany
Titolo Testata:
PEDIATRIC RESEARCH
fascicolo: 1, volume: 50, anno: 2001,
pagine: 34 - 43
SICI:
0031-3998(200107)50:1<34:ARPHSD>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS SYNDROME; HYALINE-MEMBRANE DISEASE; BRONCHIOLAR EPITHELIAL LESIONS; BIRTH-WEIGHT INFANTS; EXOGENOUS SURFACTANT; PRETERM LAMBS; TIDAL VOLUME; GAS-EXCHANGE; RABBIT MODEL; ARTIFICIAL-VENTILATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: Krause, MF Univ Kiel, Childrens Hosp, Schwanenweg 20, D-24105 Kiel, Germany Univ Kiel Schwanenweg 20 Kiel Germany D-24105 05 Kiel, Germany
Citazione:
M.F. Krause et al., "Alveolar recruitment promotes homogeneous surfactant distribution in a piglet model of lung injury", PEDIAT RES, 50(1), 2001, pp. 34-43

Abstract

Uneven distribution of exogenous surfactant contributes to a poor clinicalresponse In animal models or respiratory distress syndrome. Alveolar recruitment at the time of surfactant administration may lead to more homogeneous distribution within the lungs and result in a superior clinical response. To investigate the effects of three different volume recruitment maneuverson gas exchange, lung function, and homogeneity of surfactant distribution, we studied 35 newborn piglets made surfactant deficient by repeated airway lavage with warm saline. Volume recruitment was achieved by either a temporal increase in tidal volume or an increase in end-expiratory pressure during surfactant administration, yielding an increase in dynamic compliance of the respiratory system of 77% in the first group and an increase in functional residual capacity of 108% in the second group. A third group of piglets (all n = 7) received a combination of both volume recruitment maneuvers,with increases in dynamic compliance of the respiratory system of 100% andin functional residual capacity of 192%. Those animals subjected to increased tidal volume showed an improved surfactant response in terms of oxygenation, ventilation, lung volumes, lung mechanics, and homogeneity of surfactant distribution. Increased end-expiratory volume augmented the surfactant effect only to some extent. The combination of both volume recruitment maneuvers, however, Uneven distribution of exogenous surfactant contributes to a needed lung volumes beyond total lung capacity (approximately 56 mL/kg), thus probably inducing early sequelae of ventilator-induced lung injury. Weconclude that volume recruitment by means of increased tidal volumes at the time of surfactant administration leads to a superior surfactant effect owing to more homogeneous surfactant distribution within a collapsed lung.

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Documento generato il 02/04/20 alle ore 13:07:03