Aerosolized surfactant and dextran for experimental acute respiratory distress syndrome caused by acidified milk in rats
Article first published online: 10 JUL 2003
Acta Anaesthesiologica Scandinavica
Volume 47, Issue 7, pages 853–860, August 2003
How to Cite
Cui, XG., Tashiro, K., Matsumoto, H., Tsubokawa, Y. and Kobayashi, T. (2003), Aerosolized surfactant and dextran for experimental acute respiratory distress syndrome caused by acidified milk in rats. Acta Anaesthesiologica Scandinavica, 47: 853–860. doi: 10.1034/j.1399-6576.2003.00168.x
- Issue published online: 10 JUL 2003
- Article first published online: 10 JUL 2003
- Accepted for publication 20 March 2003
- Acute respiratory distress syndrome;
- aspiration pneumonitis;
- pulmonary surfactant;
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.