Surfactant Supplementation in the Preterm Rabbit: Effects of Applied Volume on Compliance and Survival

Metcalfe, IS; Burgoyne, Rosmarie; Enhörning, Göran

doi:10.1203/00006450-198210000-00007

Cited by 27 publications

(9 citation statements)

References 16 publications

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“…Surfactant treatments of premature rabbit lungs improve lung compliance with a "dose-response curve" that demonstrates no further improvements in compliance measurements at doses of surfactant > 1.1 mg surfactant lipid/g lung (22). The compliance changes were insensitive to the volume used to instill the surfactant.…”

Section: Discussionmentioning

confidence: 91%

Surfactant and pulmonary blood flow distributions following treatment of premature lambs with natural surfactant.

Jobe¹,

Ikegami²,

Jacobs³

et al. 1984

J. Clin. Invest.

123

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Abstract. Prematurely delivered lambs were treated with radiolabeled natural surfactant by either tracheal instillation at birth and before the onset of mechanical ventilation, or after 23±1 (±SE) min of mechanical ventilation. Right ventricular blood flow distributions, left ventricular outputs, and left-to-right ductal shunts were measured with radiolabeled microspheres. After sacrifice, the lungs of lambs receiving surfactant at birth inflated uniformly with constant distending pressure while the lungs of lambs treated after a period of ventilation had aerated, partially aerated, and atelectatic areas. All lungs were divided into pieces which were weighed and catalogued as to location. The amount of radiolabeled surfactant and microsphere-associated radioactivity in each piece oflung was quantified. Surfactant was relatively homogenously distributed to pieces of lung from lambs that were treated with surfactant at birth; 48% of lung pieces received amounts of surfactant within ±25% of the mean value. Surfactant was preferentially recovered from the aerated pieces of lungs of lambs treated after a period of mechanical ventilation, and the distribution of surfactant to these lungs was very nonhomogeneous. Right ventricular blood flow distributions to the lungs were quite homogeneous in both groups of lambs. However, in 8 of 12 lambs, pulmonary blood flow was preferentially directed away from those pieces of lung that received relatively large amounts of surfactant and toward pieces oflung that received less surfactant. This acute redirection of pulmonary blood flow distribution may result from

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Section: Discussionmentioning

confidence: 91%

Surfactant and pulmonary blood flow distributions following treatment of premature lambs with natural surfactant.

Jobe¹,

Ikegami²,

Jacobs³

et al. 1984

J. Clin. Invest.

123

View full text Add to dashboard Cite

show abstract

“…Preterm rabbits treated with surfactant before the first breath had increased mortality when volumes exceeded 16% of the functional residual capacity. 17 The functional residual capacity of preterm infants with RDS is significantly decreased and the reported values can vary from 6 to 10 ml kg À1 . 18,19 Future studies should address this potential risk factor.…”

Section: Discussionmentioning

confidence: 99%

Severe airway obstruction during surfactant administration using a standardized protocol: a prospective, observational study

Tarawneh

Kaczmarek

et al. 2011

J Perinatol

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Objective: The objective of this study was to evaluate the occurrence of adverse effects during surfactant delivery, using a standardized protocol for administration and management of complications.Study Design: The protocol was developed, implemented and used for 6 months. Vital signs and ventilatory parameters were prospectively recorded during the procedure. Infants were classified into three groups, based on the occurrence and severity of complications: no, minor or major.Result: A total of 39 infants received surfactant and 19 presented some complication: 11 minor and 8 major. Six of the major complications were episodes of severe airway obstruction (SAO) and five occurred in extreme low birth weight (ELBW) infants that had more severe lung disease before surfactant delivery. Two cases of persistent pulmonary hypertension occurred in infants with birth weight>1000 g. Conclusion:This study identified a high rate of SAO and provides data to support changes in the protocol, which should include faster and more robust increases in positive inspiratory pressures in ELBW infants presenting with SAO.

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“…Dilution to 15 mg/ml saline was done to reduce the viscosity of the DPPC and DPPC/protein mixtures (9,39). Surfactant TA, DPPC/protein, and DPPC-treated animals received dosages of 50 mg/kg.…”

Section: Efficacy Of Dpp( :/Spl5-26 Mixtures 485mentioning

confidence: 99%

Mixtures of Low Molecular Weight Surfactant Proteins and Dipalmitoyl Phosphatidylcholine Duplicate Effects of Pulmonary Surfactant in Vitro and in Vivo

Smith¹,

Taeusch²,

Phelps³

et al. 1988

Pediatr Res

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ABSTRACT. Pulmonary surfactant proteins SP-B and SP-C were isolated from lavage fluids of bovine lungs and recombined (lipid/proteins, 911, wt/wt) with dipalmitoyl phosphatidylcholine for testing in vitro and in surfactantdeficient adult rats. Using a pulsating bubble surfactometer, we found that inflation pressures of bubbles at minimum radii in these mixtures were 0.34 f 0.05 cm H 2 0 (+ SD, n = 24) after 1 min. These values were not affected by increasing amounts of surfactant protein relative to dipalmitoyl phosphatidylcholine (DPPC). Minimum inflation pressures were similar to those of modified bovine surfactant, surfactant Tokyo Akita (TA) (0.33 f 0.05 cm H20, n = 7). I n vivo testing was carried out in adult rats made surfactant deficient by repeated lavage and ventilated with 100% oxygen. Rats received tracheal instillations of either air, DPPC, DPPCISP-B,C (9:1), or surfactant TA at 50 mg/kg body weight. Surfactant TA and DPPCISP-B, SP-C mixtures resulted in similar immediate and sustained improvements in arterial oxygenation (308 + 66 torr, n = 10 and 312 2 101 torr, n = 6 at 30 min posttreatment) that were significantly greater than those of sham (76 f 24 torr, n = 17) and DPPC-treated rats (64 f 32 torr, n = 7). Rats treated with either DPPC/SP-B,C mixtures or surfactant TA showed similar postmortem static lung compliances (2.3 f 0.8 ml/cm H20/kg, n = 8 and 1.9 2 0.4 ml/cm H20/kg, n = 5, respectively) that were significantly larger than sham (1.3 + 0.3 ml/cm H 2 0 / kg, n = 14) and DPPC-treated rats (1.2 f 0.2 ml/cm H20/ kg, n = 6). We conclude that simple mixtures of DPPC

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Surfactant Supplementation in the Preterm Rabbit: Effects of Applied Volume on Compliance and Survival

Cited by 27 publications

References 16 publications

Surfactant and pulmonary blood flow distributions following treatment of premature lambs with natural surfactant.

Surfactant and pulmonary blood flow distributions following treatment of premature lambs with natural surfactant.

Severe airway obstruction during surfactant administration using a standardized protocol: a prospective, observational study

Mixtures of Low Molecular Weight Surfactant Proteins and Dipalmitoyl Phosphatidylcholine Duplicate Effects of Pulmonary Surfactant in Vitro and in Vivo

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