The exogenous therapy of respiratory distress syndrome with artificial surfactants is controversial. In the present work we treated premature rabbits with artificial ultrasonic obtained surfactant suspensions [dipalmitoyldiphosphatidylcholine:dipalmitoyldiphosphatidylglycerol (DPPCDPPG) 7:3] in various physical conditions produced by changing the carrier (saline solution and amniotic fluid) or incubating at 41 °C. Nonincubated samples (S0) were nonactive, the best effect on alveolar distention being found after 8 h incubation (S8), while 16 h incubated samples (S16) were less effective. Liposomal size of the mixtures correlated with their effectiveness; small unilamellar liposomes were nonactive, large unilamellar ones were active and in presence of large multilamellar liposomes the tensioactive effect decreased. Fifty-one percent of the alveolar distention, evaluated by morphometry, was due to treatment and 11% was linearly related to body weight. The ponderal effect of body weight was mathematically excluded in order to obtain more uniform results; the resulting parameter was called true treatment influence on alveolar distention (TIAD). 15% of TIAD varied due to the carrier, with significantly better results when saline solution was used as a carrier. These findings question the hypothesis of the prevention of respiratory distress syndrome by means of intraamniotic injection of surfactants.
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