Surfactant Tracheobronchial Lavage for the Management of a Rabbit Model of Meconium Aspiration Syndrome
| Autor: | N.S. Tsoi, Chap-Yung Yeung, F.L. Chan, Barbara C.C. Lam, K.Y. Wong, K.H. Fu |
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| Rok vydání: | 2000 |
| Předmět: |
Male
Pathology medicine.medical_specialty Suction Bronchoalveolar Lavage Pulmonary surfactant Meconium Pregnancy Meconium aspiration syndrome Animals Humans Medicine Lung medicine.diagnostic_test Inhalation Pulmonary Gas Exchange business.industry Infant Newborn Pulmonary Surfactants medicine.disease Respiration Artificial Meconium Aspiration Syndrome Radiography Solutions Trachea Disease Models Animal Bronchoalveolar lavage Lavage bronchoalveolaire Anesthesia Pediatrics Perinatology and Child Health Rabbit model Female Rabbits Tracheobronchial lavage business Developmental Biology |
| Zdroj: | Neonatology. 78:129-138 |
| ISSN: | 1661-7819 1661-7800 |
| Popis: | We evaluated the effect of tracheobronchial lavage with diluted surfactant solution (bovine lipid extract surfactant, bLES) in a rabbit model of meconium aspiration. All animals were anaesthetized, tracheotomized and given 3–4 ml/kg of 25% slurry of human meconium into the endotracheal tube and mechanically ventilated for 1 h. The animals were then randomly assigned to surfactant lavage (n = 12) with 15 ml/kg of diluted surfactant at a concentration of 5.4 mg phospholipid/ml administered in aliquots of 2 ml; or simple endotracheal suction (control n = 12) when the oxygenation index (OI) was ≥15. Changes in the arterial blood gases and the histomorphological and radiological appearances of the lungs were recorded. The OI and arterial/alveolar oxygen tension (a/A PO2) of the surfactant lavage group improved significantly at 5 min post-treatment, and these improvements were observed throughout the ensuing 4 h of ventilation. There was significantly more solid content recovered by surfactant lavage compared with the control group (p = 0.0001). Radiologically, the post-treatment air space opacification scores of the lavage group were significantly lower compared with the control (p = 0.002). The post-treatment radiographs of the lavage-treated rabbits were rated by the radiologist, who was blinded to the treatment groups, as much improved in 5 and improved in 4, whereas the control rabbits were rated as much worse in 3 and worse in 4. Histological examination showed the lungs of the lavaged rabbits had significantly more normal airway (p < 0.0001), more fields showing completely normal airspace (p = 0.0001) and less fields showing severe overdistension with meconium (p = 0.0005). We concluded that lavage with diluted surfactant solution effectively washed out the meconium, improved gases exchanges, and improved the histological and radiological appearances in the rabbit model of MAS. |
| Databáze: | OpenAIRE |
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