Lung Mechanics (FRC and Static Pressure-Volume Diagram) after Endotracheal Surfactant Instillation: Preliminary Observations

Svenningsen, Nils W.; Björklund, Lars; Vilstrup, Carsten; Werner, Olof

doi:10.1159/000243843

Cited by 11 publications

(13 citation statements)

References 8 publications

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“…The results from the present study regarding FRC and CRS in infants with severe RDS are comparable to those reported previously [11,16,19,20,24,39]. Our data confirm that infants with severe RDS have non-compliant [18,43], low volume lungs [24,26,32,43].…”

Section: Discussionsupporting

confidence: 91%

“…Although some recruitment of new alveoli probably may occur, we suggest that stabilisation of alveoli already being ventilated contributed mainly to FRC response immediately after surfactant instillation with the result that compliance remained unchanged or decreased. When measurements were repeated during the first days after surfactant treatment, compliance was observed to increase in this and also other studies [6,16,38,39], probably as a result of effective alveolar recruitment.…”

Section: Discussionsupporting

confidence: 83%

“…The infants in this study treated with natural surfactant preparations responded with improved oxygenation accompanied by an increase in FRC. According to the literature, onset and magnitude of the improvement in oxygenation and of the increase in FRC are different in the published studies [11,16,19,20,24,39]. The differences in the results of various studies could be due to differences in the infants (birth weight, gestational age, acidosis, PaO 2 before treatment, FiO 2 and age at time of treatment) investigated, the use of different measurement techniques for FRC and different surfactant preparations [8,11,19,20,24].…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there are only a few reports [11,16,19,20,24,39] describing the effect of surfactant treatment on lung volume only selective in a small number of mechanically ventilated preterm human infants.…”

Section: Introductionmentioning

confidence: 99%

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Functional residual capacity and compliance of the respiratory system after surfactant treatment in premature infants with severe respiratory distress syndrome

et al. 2002

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the changes in lung function following surfactant treatment can only be explained by initial stabilisation of already aerated alveoli followed by recruitment of new gas exchange units as mechanisms involved in mediating the effect of surfactant on gas exchange. However, since no significant correlation between changes in functional residual capacity and improvement in arterial-to-alveolar oxygen tension ratio was seen, other effects of surfactant must be considered. These include local and/or systemic changes in haemodynamics.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Functional residual capacity and compliance of the respiratory system after surfactant treatment in premature infants with severe respiratory distress syndrome

et al. 2002

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“…While some animal studies suggest pressure-volume curves may be significantly improved, 44 improvement in compliance in preterm lambs treated with synthetic surfactant is small. 45 An increase in functional residual capacity (FRC) and distensibility of the lungs is reported within 1 hr of treatment in babies treated with some 46 but not other protein-containing surfactants. 47 Although babies treated with bovine surfactant have a more rapid improvement in FRC and lung compliance than babies treated with synthetic surfactant, 48 babies treated with synthetic surfactant have improved lung mechanics by 24 hr of age.…”

Section: Discussionmentioning

confidence: 99%

Tracheal aspirate surface tension in babies with hyaline membrane disease: Effects of synthetic surfactant replacement

et al. 1998

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Pulmonary mechanics in ventilated preterm infants with respiratory distress syndrome after exogenous surfactant administration: A comparison between two surfactant preparations

Choukroun

Llanas

Apere

et al. 1994

Pediatric Pulmonology

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The effects of two surfactant preparations on lung mechanics have been studied on 24 ventilated premature infants with respiratory distress syndrome (RDS): 13 were given artificial surfactant (Exosurf Neonatal, Burroughs-Wellcome) and 11 natural porcine surfactant (Curosurf, Laboratoire Serono France). Measurements of respiratory system compliance (Cdyn, Crs) and resistance (Rrs) were performed immediately before surfactant administration and repeated 6, 18, 24, 48, and 72 hours later. With Exosurf treatment, 6 hours after surfactant administration inhaled O2 concentration (FlO2) could be lowered from (0.72 +/- 0.20, to 0.62 +/- 0.33; P < 0.05), whereas Crs did not change (0.37 mL/cmH2O/kg, +/- 0.14 vs. 0.39 +/- 0.12, NS). After 24 hours and during the following days a significant increase in Crs occurred (24 hours post-Exosurf: 0.51 +/- 0.18, P < 0.05). With Curosurf treatment, the improvement in oxygenation was greater and FlO2 could be lowered much more after 6 hours (from FlO2, 0.78 +/- 0.23 to 0.34 +/- 0.11, P < 0.01). This was associated with an increase in Crs (from 0.39 +/- 0.09 to 0.59 +/- 0.17, P < 0.05). During the following days, Crs was significantly higher in the group treated with Curosurf. Resistance was not altered by the type of surfactant preparation used except after 72 hours, when Rrs increased in the group treated with Exosurf. In conclusion, Curosurf appears to be more effective than Exosurf with regard to immediate pulmonary changes in ventilator treated premature infants with RDS. A rapid increase in Crs after Curosurf treatment indicates that recruitment of new functional areas of the lung is likely to be associated with a stabilization of small airways and alveolar units.

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Lung Mechanics (FRC and Static Pressure-Volume Diagram) after Endotracheal Surfactant Instillation: Preliminary Observations

Cited by 11 publications

References 8 publications

Functional residual capacity and compliance of the respiratory system after surfactant treatment in premature infants with severe respiratory distress syndrome

Functional residual capacity and compliance of the respiratory system after surfactant treatment in premature infants with severe respiratory distress syndrome

Tracheal aspirate surface tension in babies with hyaline membrane disease: Effects of synthetic surfactant replacement

Pulmonary mechanics in ventilated preterm infants with respiratory distress syndrome after exogenous surfactant administration: A comparison between two surfactant preparations

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