Surfactant treatment impairs gas exchange in a canine model of acute lung injury

The Efficacy of Fluorocarbon, Surfactant, and Their Combination for Improving Acute Lung Injury Induced by Intratracheal Acidified Infant Formula

We conducted the current study to compare the efficacy of partial liquid ventilation (PLV), pulmonary surfactant (PSF), and their combination in ameliorating the acidified infant-formula-induced acute lung injury (ALI). In the Part I study, 42 rabbits receiving volume-controlled ventilation with positive end-expiratory pressure 10 cm H(2)O were randomly divided into 6 groups (groups noninjuryI, gas ventilation [GVi], PLVi, PSFi, PLVi-->PSFi, and PSFi-->PLVi). ALI was induced by intratracheal acidified infant formula (2 mL/kg, pH 1.8). Group GVi received neither PLV nor PSF therapy. Groups PLV and PSF received intratracheal fluorocarbon 15 mL/kg or surfactant 100 mg/kg, respectively, 30 min after acidified infant formula. Groups PLVi-->PSFi and PSFi-->PLVi received both treatments at 30-min intervals. In Part II, 42 rabbits (in 6 groups) undergoing pressure-controlled ventilation received the same drug therapies as in Part I. The lungs were excised to assess biochemical and histological damage 150 min after induction of ALI. In Parts I and II, PSF, fluorocarbon, and their combination attenuated lung leukosequestration and edema and superoxide production of neutrophils, consequently improving oxygenation, lung mechanics, and pathological changes. Independent of ventilation mode, PSF followed by fluorocarbon provided the most beneficial effects and fluorocarbon followed by PSF produced the least efficacy.

On the preparation of lung strip for tissue mechanics measurement

It is widely believed that it is fundamental to degas and/or rinse the lung prior to the measurement of the tissue mechanics, so that the undesirable effects of surfactant and localized gas trapping are eliminated. However, one could hypothesize that these mechanisms are bound to disappear in the in vitro preparation since the small tissue sample remains suspended oscillating in an organ bath. To investigate the real necessity to follow these procedures, dynamic mechanical properties were studied in strips of lungs previously rinsed with saline, degassed by ventilation with 100% O(2), or without any of these prior procedures. Resistance, elastance, hysteresivity, and the amounts of airway, blood vessel, and alveolar wall were computed. There was no difference in either tissue mechanics or morphology among the groups. In conclusion, the time-consuming degassing and rinsing steps are not necessary to adequately prepare lung tissue for in vitro mechanical analysis, and eliminating these steps potentially helps preserving the intact microstructure of the tissue.