Surfactant replacement increases compliance in premature lamb lungs during partial liquid ventilation in situ

1998 ◽  
Vol 84 (4) ◽  
pp. 1316-1322 ◽  
Author(s):  
Peter Tarczy-Hornoch ◽  
Jack Hildebrandt ◽  
Thomas A. Standaert ◽  
J. Craig Jackson
Keyword(s):  
Force Balance ◽  
Exogenous Surfactant ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation ◽  
Lung Inflation ◽  
Surfactant Replacement ◽  
Improve Compliance ◽  
Alveolar Surface ◽  
Force Balance Equation

Treatments available to improve compliance in surfactant-deficient states include exogenous surfactant (ES) and either partial (PLV) or total liquid ventilation (TLV) with perfluorochemical (PFC). Because of the additional air-lung and air-PFC interfaces introduced during PLV compared with TLV, we hypothesized that compliance would be worse during PLV than during TLV. Because surfactant is able to reduce interfacial tension between air and lung as well as between PFC and lung, we further hypothesized that compliance would improve with surfactant treatment before PLV. In excised preterm lamb lungs, we used Survanta for surfactant replacement and perflubron as the PFC. Compliance during PLV was intermediate between TLV and gas inflation, both with and without surfactant. Surfactant improved compliance during PLV, compared with PLV alone. Because of the force-balance equation governing the behavior of immiscible droplets on liquid surfaces, we predict that PFC droplets spread during PLV to cover the alveolar surface in surfactant-deficient lungs during most of lung inflation and deflation but that the PFC would retract into droplets in surfactant-sufficient lungs, except at end inspiration.

Exogenous Surfactant and Partial Liquid Ventilation

1997 ◽  
Vol 156 (4) ◽  
pp. 1058-1065 ◽  
Author(s):  
JEANNE D. MROZEK ◽  
KENDRA M. SMITH ◽  
DENNIS R. BING ◽  
PAT A. MEYERS ◽  
SUSAN C. SIMONTON ◽  
...  
Keyword(s):  
Exogenous Surfactant ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation

Partial liquid ventilation in premature lambs with respiratory distress syndrome: Efficacy and compatibility with exogenous surfactant

1995 ◽  
Vol 126 (3) ◽  
pp. 412-420 ◽  
Author(s):  
Corinne Lowe Leach ◽  
Bruce Holm ◽  
Frederick C. Morin ◽  
Bradley P. Fuhrman ◽  
Michele C. Papo ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Exogenous Surfactant ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation

scholarly journals Exogenous Surfactant during Partial Liquid Ventilation: Lung Pathology.† 1550

1997 ◽  
Vol 41 ◽  
pp. 261-261
Author(s):  
Jeanne D. Mrozek ◽  
Kendra M. Smith ◽  
Susan C. Simonton ◽  
John E. Connett ◽  
Dennis R. Bing ◽  
...  
Keyword(s):  
Exogenous Surfactant ◽  
Lung Pathology ◽  
Partial Liquid Ventilation ◽  
Liquid Ventilation

Effects of exogenous surfactant on lung pressure-volume characteristics during liquid ventilation

1996 ◽  
Vol 80 (5) ◽  
pp. 1764-1771 ◽  
Author(s):  
P. Tarczy-Hornoch ◽  
J. Hildebrandt ◽  
E. A. Mates ◽  
T. A. Standaert ◽  
W. J. Lamm ◽  
...  
Keyword(s):  
Surface Tension ◽  
Interfacial Tension ◽  
Hyaline Membrane Disease ◽  
Exogenous Surfactant ◽  
Liquid Ventilation ◽  
Novel Approach ◽  
Hyaline Membrane ◽  
Volume Characteristics ◽  
Reducing Properties

Total liquid ventilation (LV) lowers airway pressures and potentially reduces barotrauma in models of hyaline membrane disease. LV eliminates surface tension by eliminating the air-perfluorochemicals (PFC) interface but does not eliminate interfacial tension (IT) at the lung/PFC interface. We hypothesized that pretreatment with exogenous surfactant before LV would shift the overall pressure-volume (PV) curve to the left, compared with LV without surfactant. Sequential quasi-static PV curves were obtained in 10 excised lungs (saline, air, PFC), with one-half randomized to exogenous surfactant replacement before LV. Analysis revealed that maximal inflation pressures were reduced during LV compared with baseline air curves. Addition of exogenous surfactant to LV further reduced maximal inflation pressures. A novel approach was used to transform these PV curves to estimates of in situ IT-volume curves. Estimated maximal IT at 20 ml/kg in preterm lamb lungs on air inflation after surfactant was 51 mN/m, compared with 40 mN/m for LV alone and with 27 mN/m for the combination of surfactant and LV. We conclude that the IT-reducing properties of the PFC studied (perflubron) can be augmented through the use of exogenous surfactant.

scholarly journals Tracheal acid or surfactant instillation raises alveolar surface tension

2018 ◽  
Vol 125 (5) ◽  
pp. 1357-1367 ◽  
Author(s):  
Tam L. Nguyen ◽  
Carrie E. Perlman
Keyword(s):  
Surface Tension ◽  
Distress Syndrome ◽  
Exogenous Surfactant ◽  
Acid Aspiration ◽  
Isolated Lungs ◽  
Lavage Solution ◽  
Alveolar Surface ◽  
Normal Lungs ◽  
Alveolar Liquid

Whether alveolar liquid surface tension, T, is elevated in the acute respiratory distress syndrome (ARDS) has not been demonstrated in situ in the lungs. Neither is it known how exogenous surfactant, which has failed to treat ARDS, affects in situ T. We aim to determine T in an acid-aspiration ARDS model before and after exogenous surfactant administration. In isolated rat lungs, we combine servo-nulling pressure measurement and confocal microscopy to determine alveolar liquid T according to the Laplace relation. Administering 0.01 N (pH 1.9) HCl solution by alveolar injection or tracheal instillation, to model gastric liquid aspiration, raises T. Subsequent surfactant administration fails to normalize T. Furthermore, in normal lungs, tracheal instillation of control saline or exogenous surfactant raises T. Lavaging the trachea with saline and injecting the lavage solution into the alveolus raises T, suggesting that tracheal instillation may wash T-raising airway contents to the alveolus. Adding 0.01 N HCl or 5 mM CaCl2—either of which aggregates mucins—to tracheal lavage solution reduces or eliminates the effect of lavage solution on alveolar T. Following tracheal saline instillation, liquid suctioned directly out of alveoli through a micropipette contains mucins. Additionally, alveolar injection of gastric mucin solution raises T. We conclude that 1) tracheal liquid instillation likely washes T-raising mucins to the alveolus and 2) even exogenous surfactant that could be delivered mucin-free to the alveolus might not normalize T in acid-aspiration ARDS. NEW & NOTEWORTHY We demonstrate in situ in isolated lungs that surface tension is elevated in an acid-aspiration acute respiratory distress syndrome (ARDS) model. Following tracheal liquid instillation, also in isolated lungs, we directly sample alveolar liquid. We find that liquid instillation into normal lungs washes mucins to the alveolus, thereby raising alveolar surface tension. Furthermore, even if exogenous surfactant could be delivered mucin-free to the alveolus, exogenous surfactant might fail to normalize alveolar surface tension in acid-aspiration ARDS.

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