Effect of recombinant SP-C surfactant in a porcine lavage model of acute lung injury

Synthetic surfactants allow examination of the effects of specific componen ts of natural surfactant. To determine whether surfactant containing apopro tein C, dipalmitoyl-phosphatidylcholine, phosphatidylglycerol, and palmitic acid restores gas-exchanging function in acute lung injury (ALI), we admin istered such surfactant tin doses of 50 or 100 mg/kg and in volumes from 1 to 6 ml/kg) or phospholipid (PL) alone, by intratracheal instillation, to p igs with ALI induced by massive saline lavage. Animals ventilated with 100% O-2 and receiving 1, 2, 4, or 6 ml/kg of 50 mg/kg recombinant surfactant a poprotein C: (rSP-C) surfactant or 2 ml/kg of 50 mg/kg PL (control) had mea n arterial PO2 values, 4 h after treatment, of 230, 332, 130, 142, or 86 To rr, respectively. Animals receiving 1, 2, or 4 ml/kg of 100 mg/kg rSP-C sur factant or 2 ml/kg of 100 mg/kg PL (control) had mean arterial PO2 values o f 197, 214, 148, or 88 Torr, respectively. Surfactant PL distribution was h omogeneous. Hyaline membrane formation pp-as reduced in treated animals. Th us, in this model of ALI, rSP-C with PL has the capacity to improve gas exc hange and possibly modify lung injury.