Abstract
In premature lambs, instillation of surfactant (S) after a period of mechanical ventilation for respiratory distress syndrome (RDS) leads to a shorter duration of the clinical response than S treatment at birth. The distribution of instilled S probably depends on the timing of administration, but also on the type of ventilation used. The effects of IMV and HFOV on the distribution of exogenous S were studied in 10 premature lambs delivered at 126-132 days of gestation. All were ventilated from birth with IMV at a FiO2 of 1.0. After respiratory failure had been documented 50 mg natural sheep S/kg body weight, labeled with 1 μCi [14C] dipalmitoyl-phosphatidylcholine, was instilled into the trachea. Ventilation was continued for 3 hours with IMV in group A (n=5) and with HFOV in group B (n=5). The lambs were than sacrificed and the distribution of labeled S over the lung was quantified.
Group B showed improved oxygenation and CO2 removal at lower mean airway pressures in comparison with group A. However, in both groups a non-homogenous distribution of labeled S was documented. Central lung areas contained in general more S than peripheral areas, where large differences in S content were found.
We conclude that (1) surfactant instillation after the establishment of RDS leads to a non-homogenous distribution over the lung, and (2) the surfactant distribution is not influenced by the type of ventilation used.
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Walther, F., Gidding, C., Van De Kamp, G. et al. 9 INFLUENCE OF HIGH FREQUENCY OSCILLATION VENTILATION (HFOV) AND INTERMITTENT MANDATORY VENTILATION (IMV) ON EXOGENOUS SURFACTANT DISTRIBUTION. Pediatr Res 20, 1035 (1986). https://doi.org/10.1203/00006450-198610000-00063
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DOI: https://doi.org/10.1203/00006450-198610000-00063
