Aerosolized surfactant and dextran for experimental acute respiratory distress syndrome caused by acidified milk in rats.

Abstract

BACKGROUND:

Inhibition of pulmonary surfactant by plasma-derived proteins is an important pathogenetic factor of acute respiratory distress syndrome (ARDS). Inhalation of aerosolized surfactant may be suitable for early treatment of ARDS. However, requirement of a high dose is a drawback. Because dextran reverses surfactant inhibition, we examined whether dextran improves the therapeutic effects of aerosolized surfactant in rats with experimental ARDS.

METHODS:

Acidified milk (pH 1.8, 1.5 ml kg(-1)) was injected into the trachea of the rats ventilated with pure oxygen using 2.45 kPa peak inspiratory pressure and 0.74 kPa positive end-expiratory pressure. When PaO2 decreased to <13 kPa, the rats were assigned to four groups: control group (n = 8), receiving no material; D-only group (n = 6), receiving aerosolized dextran for 45 min; S-only group (n = 8), receiving aerosolized modified natural surfactant (MNS) for 30 min; and S-plus-D group (n = 9), receiving aerosolized MNS for 30 min followed by aerosolized dextran for 15 min.

RESULTS:

In the control group and D-only groups, the mean PaO2 remained at <10 kPa for 180 min. In the S-only and S-plus-D groups, the PaO2 increased to 50 kPa (P < 0.01 vs. untreated). The PaO2 of the surfactant-only group gradually decreased to <17 kPa at 180 min, whereas the PaO2 of the S-plus-D group was maintained at >38 kPa for 180 min (P < 0.01 vs. S-only group).

CONCLUSION:

Inhalation of aerosolized dextran potentiates the effects of aerosolized surfactant by prolonging the therapeutic response.

• Authors: X G Cui, K Tashiro, H Matsumoto, Y Tsubokawa, T Kobayashi
• Journal: Acta anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 47 Issue 7 Pg. 853-60 (Aug 2003) ISSN: 0001-5172 [Print] England
• PMID: 12859307 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Aerosols
• Anticoagulants
• Dextrans
• Pulmonary Surfactants
• Oxygen

Topics

• Aerosols
• Analysis of Variance
• Animals
• Anticoagulants (therapeutic use)
• Dextrans (therapeutic use)
• Disease Models, Animal
• Inhalation Exposure (adverse effects)
• Male
• Milk (adverse effects, chemistry)
• Oxygen (administration & dosage)
• Pulmonary Surfactants (administration & dosage, therapeutic use)
• Rats
• Rats, Wistar
• Respiration, Artificial
• Respiratory Distress Syndrome (chemically induced, drug therapy, pathology)
• Respiratory Function Tests
• Time Factors