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Pulmonary clearance of 99m Tc‐DTPA in experimental surfactant dysfunction treated with surfactant instillation
Author(s) -
NILSSON K.,
JOHN J.,
LACHMANN B.,
ROBERTSON B.,
WOLLMER P.
Publication year - 1997
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1997.tb04682.x
Subject(s) - pulmonary surfactant , saline , medicine , clearance rate , clearance , pulmonary compliance , respiratory system , respiratory distress , lung , anesthesia , chemistry , urology , biochemistry
Background: Breakdown of the alveolo‐capillary barrier is a characteristic feature of respiratory distress syndrome. Restoration of alveolo‐capillary barrier function may be an important aspect of surfactant raplacement therapy. We examined the effect of surfactant instillation on alveolo‐capillary barrier function in an experimental model of surfactant dysfunction by measuring pulmonary clearance of 99m Tc‐DTPA. Methods: Nineteen rabbits were tracheotomized and mechanically ventilated. Surfactant dysfunction was induced by administration of a synthetic detergent in aerosol form. Detergent was given to 13 rabbits; seven rabbits were then treated with instillation of natural surfactant, whereas six rabbits received saline. Six rabbits were used as untreated controls. An aerosol of 99m Tc‐DTPA was administered to all animals and the pulmonary clearance was measured with a gamma camera. Results: 99m Tc‐DTPA cleared from the lungs with a half‐life of 71±22 min in the control animals, 21.4±7.4 min in the sur factant‐treated animals and 5.8±1.5 min in the saline‐treated animals. The difference in half‐life between groups was highly significant ( P <0.001). There was no change in arterial oxygen‐ation or compliance in controls or in animals treated with saline. In animals treated with surfactant, a small transient reduction in arterial oxygen tension and a more long‐standing reduction in compliance were observed. Conclusions: Surfactant treatment thus significantly attenuated the effect of detergent treatment but did not restore alveolo‐capillary transfer of 99m Tc‐DTPAto normal.