Ep. Eijking et al., PREVENTION OF RESPIRATORY-FAILURE AFTER HYDROCHLORIC-ACID ASPIRATION BY INTRATRACHEAL SURFACTANT INSTILLATION IN RATS, Anesthesia and analgesia, 76(3), 1993, pp. 472-472
Because the surfactant system probably is involved in the pathophysiol
ogy of respiratory failure caused by hydrochloric acid (HCl) aspiratio
n, we investigated the effects of different ventilation strategies and
intratracheal surfactant instillation at different time intervals on
the course of pulmonary gas exchange after HCl aspiration in rats. In
this study rats were anesthetized and mechanically ventilated via a tr
acheostomy. Respiratory failure was induced by intratracheal instillat
ion of 3 mL/kg 0.1 N HCl. Animals (n = 49) were divided into nine grou
ps: Groups 1 and 2 through 9 were ventilated with peak airway pressure
/positive end-expiratory pressure of 14/2 and 26/6 cm H2O, respectivel
y; Groups 3 and 4 received surfactant (200 mg/kg) intratracheally, 1 a
nd 10 min after HCl aspiration; Groups 5 and 6 received saline, 1 and
10 min after HCl aspiration; Groups 7 and 8 received surfactant, 60 an
d 90 min after HCl aspiration; Group 9 received saline instead of HCl.
Gas exchange deteriorated in Groups 1, 2, 5, 6, 7, and 8, whereas res
piratory failure could be prevented in Groups 3 and 4. After deteriora
tion of gas exchange, surfactant treatment prevented further decrease
of PaO2 values in Group 7, whereas no effect on gas exchange was obser
ved in Group 8; intratracheal instillation of saline had no effect on
gas exchange (Group 9). These results suggest that surfactant should b
e given as early as possible after aspiration of gastric contents to p
revent development of respiratory failure.