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Improved oxygenation with exogenous surfactant administration in experimental meconium aspiration syndrome
Author(s) -
AlMateen K. Bakeer,
Dailey Kimberly,
Grimes Margaret M.,
Gutcher Gary R.
Publication year - 1994
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950170202
Subject(s) - medicine , meconium aspiration syndrome , pulmonary surfactant , meconium , atelectasis , anesthesia , oxygenation , lung , pulmonary compliance , pregnancy , fetus , genetics , physics , biology , thermodynamics
Abstract Fifteen adult New Zealand white rabbits were used to determine if exogenous surfactant immediately improves oxygenation in experimental meconium aspiration syndrome (MAS). They were ventilated with 100% 0 2 before insufflating 3 mL/kg of 40% filtered meconium. Arterial blood gases, dynamic lung compliance (C Ldyn ) and resistance (R L ) were monitored for 2 hours before and 1 hour after the intratracheal administration of calf lung surfactant extract or air placebo. The arteriallalveolar O 2 tension ratio [P (a/A)O 2] increased 133% within 1 hour of surfactant therapy but C Ldyn did not change. The increase of R L , was comparable in the surfactant and control groups after meconium instillation. A further increase of 44% in R L occurred after surfactant administration with no change in the controls. Qualitative histologic analysis confirmed the presence of alveolar meconium as well as inflammation and atelectasis. Persistently elevated R L suggested airway obstruction in both groups throughout the study. Most likely no increase in C Ldyn occurred with surfactant administration or it could not be detected because it was measured only with ventilator‐induced breaths and ventilator settings were held constant. In the face of airway obstruction C Ldyn is an inadequate reflection of pulmonary elasticity. We conclude that exogenous surfactant therapy improves oxygenation in this model of MAS. Further studies are needed to understand the mechanism of this improvement. Pediatr Pulmonol. 1994; 17:75–80 . © 1994 Wiley‐Liss, Inc.