Bronchoalveolar Lavage plus Surfactant in a Piglet Model of Meconium Aspiration Syndrome

Abstract

Introduction: Meconium aspiration produces airway obstruction and surfactant inhibition. Bronchoalveolar lavage (BAL) and surfactant replacement have been proposed as treatments for the syndrome. Objective: To evaluate the effect of BAL with normal saline followed by a supplementary dose of surfactant in a piglet model of meconium aspiration syndrome. Methods: 15 newborn piglets were used in the study. The animals were ventilated with fixed settings. After inhalation of 4 ml/kg of diluted meconium, the piglets were randomized into three groups: group I (n = 5) – tracheal aspiration without BAL; group II (n = 5) – BAL with normal saline (15 ml/kg), and group III (n = 5) – BAL with normal saline (15 ml/kg) followed by a supplementary dose of surfactant (Curosurf® 100 mg/kg). Arterial blood gas samples were obtained 30 min and 6 h after the inhalation of meconium. Results: A significant increase of PaO₂values at 6 h after treatment was only observed in group III (from 51 ± 13 to 189 ± 115 mm Hg; p = 0.04). At this time, PaO₂ in group III was significantly higher compared to group II (189 ± 115 and 37 ± 11 mm Hg, respectively; p = 0.023) and showed a borderline significance when compared to group I (p = 0.066). Conclusion: BAL with normal saline followed by a supplementary dose of surfactant may improve oxygenation in an experimental piglet model of meconium aspiration syndrome.

Irradiance of phototherapy equipment in maternity wards in Maceió

“…Comparing the irradiances in limit parameters of emitted dosage, we verified that 27.76% of the devices emitted irradiance below 4 mw/cm 2 /nm, which is the irradiance with the least efficacious dose for jaundice treatment by phototherapy (6,8,11) .…”

“…These devices present an irradiance two to three times higher than that observed in devices with white bulbs (6,8) . This kind of bulb is not made in Brazil and its importation is hindered by administrative bureaucracy and high costs (9) .…”

“…The conventional or common phototherapy uses from six to eight white fluorescent bulbs (day light) (6) ; some devices already have interspersed blue bulbs, at least two. The minimum irradiance of this device is 4mw/ cm 2 /nm (5)(6)(7)(8) .…”

“…Halogen-tungsten bulbs are used and these emit irradiance in a blue range of 25 to 30mw/cm 2 /nm and filters for infrared and ultraviolet radiation, however, its distribution is irregular, unlike the conventional, and gives a very high peak in the center (10) . Bilispot ® 006-BP bulbs have to be changed when irradiance is below 10 mw/cm 2 /nm (8) .…”

Characterization of an Optical Device with an Array of Blue Light Emitting Diodes LEDS for Treatment of Neonatal Jaundice.

“…The phototherapy for neonates is applied to break down the bilirubin, an organic pigment that is a sub product of the erythrocytes degradation, and to increase its excretion by the organism [1,2]. An elevated concentration of bilirubin in the neonate blood is known as neonatal jaundice [3][4][5]. The first clinical application of the neonatal phototherapy was reported by Cremer at al.…”