Introduction: In utero ligation of the fetal trachea(CDH+TL) reverses the pulmonary hypoplasia associated with Congenital Diaphragmatic Hernia (CDH), but produces a severely surfactant deficient lung(O'Toole et al 1995, Pediatr Res; 37, A 228). Previously we reported improvement in pulmonary hemodynamics after surfactant replacement in the lamb model of CDH (O'Toole et al 1995, Pediatric Res; 37, A 227) Here we report our observations of pulmonary blood flow in the surfactant deficient fetal lamb model of CDH+TL.

Method: CDH was created in fetal lambs at 78 days gestation. Ligation of the fetal trachea was performed during a second procedure at 110 days (n=6), unoperated litter mates served as controls (n=6). Animals were instrumented at term with ultra-sonic transit time flow probes to measure pulmonary blood flow. They were then ventilated for 4 hours. Total lung blood flow was recorded and then normalized for lung weight. In a second series CDH+TL lambs (n=2)were given surfactant replacement (Infasurf, Ony Inc, Buffalo, NY 50mg/kg).

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