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PEDIATRIC ANESTHESIA

Intratracheal Application of Recombinant Surfactant Protein-C Surfactant to Rabbits Attenuates Acute Lung Injury Induced by Intratracheal Acidified Infant Formula

Department of Anesthesia and Perioperative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

Address correspondence and reprint requests to Katsuya Mikawa, MD, Department of Anesthesia and Perioperative Medicine, Kobe University Graduate School of Medicine, Kusunoki-cho 7, Chuo-ku, Kobe 650-0017, Japan. Address e-mail to katzmikawa{at}yahoo.co.jp

Our aim in the current study was to determine whether recombinant surfactant protein-C (rSP-C) surfactant improves acute lung injury (ALI) induced by intratracheal acidified milk products. Twenty-eight rabbits were randomly divided into four groups. ALI was induced with intratracheal acidified infant formula (0.8 mL/kg, pH 1.8) in 3 groups. The control group received intratracheal acidified saline. Therapy groups received 1 of 2 doses of intratracheal rSP-C surfactant (0.5 or 2 SP-C mg/kg) 30 min after the acidified infant formula. The lungs were ventilated with 100% oxygen for 4 h after induction of ALI. Acidified infant formula dramatically reduced oxygenation and lung compliance, and increased resistance. Both doses of rSP-C improved the variables [mean PaO₂ (mm Hg) and compliance (mL/cm H₂O) at 4 h: 61 and 0.4 for infant formula, 162 and 1.0 for small-dose rSP-C, and 152 and 1.2 for large-dose rSP-C, respectively; P < 0.05]. Pulmonary leukosequestration and edema, and severe morphological changes were attenuated by rSP-C treatment (ALI score: 14, 7, 7 in infant formula, small-dose rSP-C, and large-dose rSP-C; P < 0.05). The efficacy was similar for the two doses of rSP-C. These findings suggest that intratracheal administration of rSP-C ameliorates ALI induced by aspiration of acidified milk products.

IMPLICATIONS: Small or large doses of recombinant surfactant protein-C surfactant given 30 min after intratracheal acidified infant formula attenuated physiological, biochemical, and morphological lung damage.

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				K. Nishina, K. Mikawa, Y. Takao, and H. Obara The Efficacy of Fluorocarbon, Surfactant, and Their Combination for Improving Acute Lung Injury Induced by Intratracheal Acidified Infant Formula Anesth. Analg., April 1, 2005; 100(4): 964 - 971. [Abstract] [Full Text] [PDF]