Sl. Sood et al., EXOGENOUS SURFACTANT DECREASES OXYGENATION IN ESCHERICHIA-COLI ENDOTOXIN-TREATED NEONATAL PIGLETS, Pediatric pulmonology, 22(6), 1996, pp. 376-386
Abnormalities of pulmonary surfactant function have been described in
association with the acute respiratory distress syndrome (ARDS). Becau
se gram-negative sepsis is a common cause of ARDS, we treated neonatal
piglets with Escherichia coli endotoxin to create a neonatal ARDS mod
el. We hypothesized that under these conditions administration of exog
enous surfactant would improve pulmonary function. Study groups includ
ed: control (n = 8), Exosurf(R) (5 mL/kg, 13.5 mg phospholipid/mL, n =
7), Survanta(R) (4 mL/kg, 25 mg phospholipid/mL, n = 6), and saline (
5 mL/kg, n = 6). E. coli endotoxin 12 mu g/kg was infused over 30 min
and resulted in significant pulmonary and hemodynamic abnormalities, h
istopathologic evidence of nonhomogeneous lung injury, and elevated pr
otein levels in bronchoalveolar lavage washings. Neither Exosurf(R) no
r Survanta(R) ameliorated the pulmonary effects of endotoxin. Instead,
there was a prolonged decrease in arterial oxygen tension (PaO2) and
dynamic lung compliance after administration of surfactant and saline.
Distribution of a bolus of Exosurf(R) was uneven throughout the lung.
We conclude that in this neonatal piglet model of ARDS, bolus surfact
ant administration had a detrimental effect on oxygenation and pulmona
ry function. (C) 1996 Wiley-Liss, Inc.