Intratracheal Surfactant Administration Preserves Airway Compliance During Lung Reperfusion

Buchanan, Scott; Mauney, Michael C.; Parekh, Vikas I.; DeLima, Nuno F.; Binns, Oliver A.R.; Cope, Jeffrey T.; Shockey, Kimberly S.; Tribble, Curtis G.; Krön, Irving L.

doi:10.1016/s0003-4975(96)00612-1

Cited by 21 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This assumption is supported by the fact that under these conditions (1) maneuvers aiming to reduce the I/R-injury related response, as shown in this study, simultaneously attenuate the deterioration of surfactant properties and also the worsening of gas exchange; (2) exogenous surfactant administration restores physiological surfactant properties and function and at the same time prevents the loss of gas exchange properties and compliance, 17,19,34 and (3) preservation-related improvements in post-ischemia lung function are associated with improved ultrastructural preservation of pulmonary surfactant. 35,36 Despite the obvious efficacy of the IPC-5 and the endotoxin protocol in preventing surfactant alterations and in maintaining a highly efficient gas exchange, several questions remain:…”

Section: Discussionmentioning

confidence: 59%

Ischemic and Endotoxin Pre-Conditioning Reduce Lung Reperfusion Injury-Induced Surfactant Alterations

Markart

Schmidt

Ruppert

et al. 2005

The Journal of Heart and Lung Transplantation

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 59%

Ischemic and Endotoxin Pre-Conditioning Reduce Lung Reperfusion Injury-Induced Surfactant Alterations

Markart

Schmidt

Ruppert

et al. 2005

The Journal of Heart and Lung Transplantation

View full text Add to dashboard Cite

“…Several studies have identified the important role of surfactant alterations in transplantationrelated I/R injury of the lung [8,9,[35][36][37][38][39][40]. Accordingly, exogenous surfactant therapy has been applied successfully in experimental [12][13][14][15][16][17][18][19][20][21] and clinical [22][23][24] studies. It is, therefore, considered a potentially promising therapy for the mitigation of severe lung I/R injury, although the optimal surfactant preparation and mode of therapy still need to be determined [26,41].…”

Section: Discussionmentioning

confidence: 99%

“…Several experimental [12][13][14][15][16][17][18][19][20][21] and clinical [22][23][24] studies give evidence that exogenous surfactant therapy successfully supplements the imbalanced endogenous surfactant system, serving to attenuate I/R injury and effectively improve lung preservation and graft function [11]. The great advantage of exogenous surfactant therapy of the donor in human lung transplantation is the fact that PGD in this case can accurately be predicted and, thus, even be prevented, providing a promising approach for prophylactic surfactant therapy [11,25,26].…”

mentioning

confidence: 99%

Pre-ischaemic exogenous surfactant reduces pulmonary injury in rat ischaemia/reperfusion

Mühlfeld¹,

Schaefer²,

Becker³

et al. 2008

Eur Respir J

View full text Add to dashboard Cite

The optimal timing of exogenous surfactant application to reduce pulmonary injury and dysfunction was investigated in a rat lung ischaemia and reperfusion injury model.Lungs were subjected to flush perfusion, surfactant instillation, cold ischaemia (4uC, 4 h) and reperfusion (60 min). Animals received surfactant before (group 1) or at the end (2) of ischaemia, or during reperfusion (3) or not at all (4). Control groups included ''worst case'' without Perfadex and surfactant (5), ''no injury'' without (6) or with surfactant (7), and ischaemia with pre-ischaemic surfactant (8). Intra-alveolar oedema and blood-air barrier injury were estimated by light and electron microscopic stereology. Perfusate oxygenation and pulmonary arterial pressure (Ppa) were determined during reperfusion in groups 1 to 4.Intra-alveolar oedema was almost absent in groups 1, 6, 7 and 8, pronounced in 2, 3 and 4, and severe in 5. Blood-air barrier injury was moderate in groups 1 and 8, slightly pronounced in 2, 3 and 4, extensive in 5 and almost absent in 6 and 7. Perfusate oxygenation was significantly higher in group 1 compared with groups 2 to 4. Ppa did not differ between the groups.In conclusion, exogenous surfactant attenuates intra-alveolar oedema formation and blood-air barrier damage and improves perfusate oxygenation in the rat lung, especially when applied before ischaemic storage.

show abstract

“…Pulmonary surfactant is a complex mixture of mainly lipids and surfactant proteins that plays an important role in surface tension-lowering properties and is important for lung function after preservation and reperfusion [26][27][28] . Increase in total protein in BAL fl uid refl ects injury of the alveolar cells and increased alveolocapillary membrane permeability [29] .…”

Section: Tissue Propertiesmentioning

confidence: 99%

“…It is possible that lung injury during cold storage, such as edema, increased permeability and cell injury, may lead to changes in the electromechanical properties of PG. There are many reports about the change in membrane permeability after PA fl ushing and longer ischemia [11,32,33] , leading to pulmonary edema [27] . The reports show that the infl ux and/or effl ux of water, protein and electrolyte, such as Na + , K + and calcium, occur in interstitial tissue.…”

Section: Tissue Propertiesmentioning

confidence: 99%

Influence of Inflated Lung Pressure on Lung Mechanical Properties during Cold Storage in Rats

Ikeyama

Sakai²,

Omasa³

et al. 2006

Eur Surg Res

View full text Add to dashboard Cite

The degree of lung inflation pressure during cold storage has a deep connection with lung functions after reperfusion. However, the change of the lung mechanical properties during cold storage at the different lung inflation pressure is unknown. We investigated the change of the mechanical properties both at the organ and the tissue level under different inflated lung pressure soon after the cold storage. In group I, the lungs were not preserved. In group II, the lungs were preserved in deflated condition. In groups III and IV, the lungs were inflated with room air at pressures of 14 and 25 cm H₂O. After 24-hour storage, the input impedance (Z) was measured by a computer-controlled small animal ventilator (n = 8 each group). All data were analyzed using a homogeneous linear model, which includes airway resistance (R_aw), tissue elastance (H), and tissue damping (G). Hysteresivity (η) was calculated as G/H. After Z measurement, the tissue elasticity (Eqs) obtained from the quasi-static stress-strain curve was compared. We also analyzed the biochemical changes of surfactant in bronchoalveolar lavage (BAL) fluid. R_awwas significantly lower in groups III and IV than in group I (p < 0.01). Hysteresivity (η) was significantly lower in group IV than in groups I and III (p < 0.05). Eqs was significantly higher in groups III and IV than in groups I and II (p < 0.01). The total protein level in the BAL fluid of the preserved groups was significantly higher compared with group I (p <0.01). We conclude that hyperinflated storage would deteriorate lung tissue mechanical properties.

show abstract

Intratracheal Surfactant Administration Preserves Airway Compliance During Lung Reperfusion

Cited by 21 publications

References 12 publications

Ischemic and Endotoxin Pre-Conditioning Reduce Lung Reperfusion Injury-Induced Surfactant Alterations

Ischemic and Endotoxin Pre-Conditioning Reduce Lung Reperfusion Injury-Induced Surfactant Alterations

Pre-ischaemic exogenous surfactant reduces pulmonary injury in rat ischaemia/reperfusion

Influence of Inflated Lung Pressure on Lung Mechanical Properties during Cold Storage in Rats

Contact Info

Product

Resources

About