Effects of Ventilation Strategies on the Efficacy of Exogenous Surfactant Therapy in a Rabbit Model of Acute Lung Injury

• DOI: 10.1164/ajrccm.157.1.9701073
• Publication Date: 2013-04-04T17:30:55Z
• Authors: YUSHI ITO; STUART E. E. MANWELL; CAROLYN L. KERR; RUUD A. W. VELDHU...; LI-JUAN YAO; DAVE BJARNESON; LYNDA A. McCAIG; ADRIENNE J. BARTLETT; JAMES F. LEWIS
• Keywords: Positive End-Expiratory Pressure

We evaluated the effects of various ventilation strategies on efficacy exogenous surfactant therapy in lung-injured adult rabbits. Lung injury was induced by repetitive whole-lung saline lavage followed mechanical ventilation. Three hours after final lavage, 100 mg lipid/kg bovine lipid extract instilled. After confirmation similar responses to surfactant, animals were then randomized one four groups; (1) Normal tidal volume (Vt) (5 cm H2O): Vt = 10 ml/kg, respiratory rate (RR) 30/min, positive end-expiratory pressure (PEEP) 5 H2O; (2) (9 RR PEEP 9 (3) Low 60/min, (4) H2O. Animals ventilated for an additional 3 h and killed, lung fluid analyzed. with low-Vt modes (Low [5 H2O] [9 H2O]) had higher PaO2 values (430 ± 7 mm Hg 425 18 versus 328 13 Hg) percentages large aggregate forms (83 2% 82 67 4%) at treatment than did H2O) group (p < 0.05). Increasing level beneficial a short period administration maintain oxygenation, but not affect conversion. speculate that resulting low conversion will result superior physiologic surfactant.