OBJECTIVE: To assess whether bronchoalveolar lavage (BAL) with a diluted surfactant suspension prior to surfactant instillation prevents the only transient improvement in lung function as reported after surfactant instillation in severe acute respiratory distress syndrome (ARDS). DESIGN: Randomized, prospective, experimental study. SETTING: Laboratory and animal facility of a large university. MATERIALS: Adult male Sprague-Dawley rats (280 +/- 30 g). INTERVENTIONS: All animals underwent repetitive whole lung saline lavage to induce acute lung injury. Then, animals were randomly divided into seven study groups: the first group received surfactant (150 mg/ kg) within 10 min after the last lavage (early treatment), whereas in the other six groups mechanical ventilation was continued for 3 h before treatment (late treatment). Treatment consisted of: surfactant instillation at a dose of 150 mg/kg; at a dose of 250 mg/kg; BAL with saline; BAL with a diluted surfactant suspension (2.5 mg/ml); BAL with saline, immediately followed by surfactant instillation (150 mg/kg) and BAL with a diluted surfactant suspension (2.5 mg/kg), immediately followed by surfactant instillation (150 mg/kg). MEASUREMENTS AND RESULTS: Blood gases were measured for 6 h and then BAL was performed to measure the protein concentration and surface tension properties. Mean PaO2 values increased immediately after surfactant instillation to pre-lavage values but remained stable only in the group that received surfactant immediately after the lavage procedure and the group that underwent BAL with a diluted surfactant suspension prior to surfactant instillation. CONCLUSION: BAL with a diluted surfactant suspension prior to surfactant instillation at a later time point in lung injury resulted in a stable improvement of lung function. This improvement is comparable with the results seen after surfactant instillation immediately after lung lavage.
OBJECTIVE: To assess whether bronchoalveolar lavage (BAL) with a diluted surfactant suspension prior to surfactant instillation prevents the only transient improvement in lung function as reported after surfactant instillation in severe acute respiratory distress syndrome (ARDS). DESIGN: Randomized, prospective, experimental study. SETTING: Laboratory and animal facility of a large university. MATERIALS: Adult male Sprague-Dawley rats (280 +/- 30 g). INTERVENTIONS: All animals underwent repetitive whole lung saline lavage to induce acute lung injury. Then, animals were randomly divided into seven study groups: the first group received surfactant (150 mg/ kg) within 10 min after the last lavage (early treatment), whereas in the other six groups mechanical ventilation was continued for 3 h before treatment (late treatment). Treatment consisted of: surfactant instillation at a dose of 150 mg/kg; at a dose of 250 mg/kg; BAL with saline; BAL with a diluted surfactant suspension (2.5 mg/ml); BAL with saline, immediately followed by surfactant instillation (150 mg/kg) and BAL with a diluted surfactant suspension (2.5 mg/kg), immediately followed by surfactant instillation (150 mg/kg). MEASUREMENTS AND RESULTS: Blood gases were measured for 6 h and then BAL was performed to measure the protein concentration and surface tension properties. Mean PaO2 values increased immediately after surfactant instillation to pre-lavage values but remained stable only in the group that received surfactant immediately after the lavage procedure and the group that underwent BAL with a diluted surfactant suspension prior to surfactant instillation. CONCLUSION: BAL with a diluted surfactant suspension prior to surfactant instillation at a later time point in lung injury resulted in a stable improvement of lung function. This improvement is comparable with the results seen after surfactant instillation immediately after lung lavage.
Authors: Michael M Hermon; Johann Golej; Wolfgang Emminger; Stefan Puig; Zsolt Szepfalusi; Gerhard Trittenwein Journal: Wien Klin Wochenschr Date: 2003-11-28 Impact factor: 1.704
Authors: Jens Christian Möller; Thomas Schaible; Claudia Roll; Jan-Holger Schiffmann; Lutz Bindl; Lothar Schrod; Irwin Reiss; Martina Kohl; Subha Demirakca; Roland Hentschel; Thomas Paul; Anne Vierzig; Peter Groneck; Heide von Seefeld; Helmut Schumacher; Ludwig Gortner Journal: Intensive Care Med Date: 2003-02-15 Impact factor: 17.440