Partielle Flüssigkeitsbeatmung in Kombination mit Surfactanttherapie : Auswirkungen auf Gasaustausch und Lungenpathologie im Neugeborenen-Tiermodell
Objective: To evaluate the effects of 24 h partial liquid ventilation (PLV) with and without surfactant (S) treatment on gas exchange and lung injury in a newborn animal model of S deficiency. Design: A prospective, controlled, in vivo animal laboratory study. Setting: Research laboratory in a university setting. Subjects: Twenty-four pathogen-free, male piglets (weight 1,5-2,5 kg, age 1-3 days). Interventions: The animals were randomised in four groups: PLV with FC-77 combined with conventional ventilation (PLV/CV) versus S + PLV/CV and PLV combined with high frequency oscillation (PLV/HFOV) versus S + PLV/HFOV. The piglets were anaesthetised, intubated and instrumented with vascular catheters. Thirty minutes after lung injury had been induced with repeated saline lavage, S animals received natural S. Thirty minutes after surfactant substitution PLV with FC-77 was started. The oxygenation index (OI), PaO2/FiO2 ratio and PaCO2 were determined before and during PLV. After 24 h the lungs were removed for histopathological examination. Measurements and main results: Within 60 minutes after the initiation of PLV all animals demonstrated improvements of the OI and PaO2/FiO2 ratio compared to the values after lung injury. However, at 18 and 24 h of PLV, the OI and PaO2/FiO2 ratio were significantly worse in the S + PLV/CV and S + PLV/HFOV groups compared to the groups without S. PaCO2 was higher at 18 and 24 h when S was used in PLV/HFOV. A semi-quantitative lung injury score revealed most severe lung damage in the S + PLV/HFOV group. Conclusions: The combination of S and PLV with FC-77 led to an impaired gas exchange and did not further protect the animal from lung injury.
info:eu-repo/classification/ddc/610, Medizin
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