Evaluation of two exogenous surfactant preparations and delivery
methods in an adult model of acute lung injury.
Lewis, Jim F, John Goffin, Paul Yue, Lynda A McCaig, Dave Bjarneson,
Ruud Aw Veldhuizen.
Department of Medicine, Lawson Research Institute, University of
Western Ontario, London, Ontario, Canada N6A 4V2
APStracts 2:0511A, 1995.
Two exogenous surfactant preparations (Survanta_ and Bovine Lipid
Extract Surfactant, (BLES_)) were evaluated in saline lavage-injured
adult sheep using two different delivery methods (instillation versus
aerosolization). Instilled BLES resulted in the greatest improvement
in lung function followed by aerosolized Survanta and instilled
Survanta. Aerosolized BLES was ineffective. Total surfactant recovery
and distribution patterns were similar for Survanta and BLES for each
delivery method tested. There were significant differences, however,
in the proportion of surfactant recovered in the alveolar wash
relative to lung tissue between the groups at sacrifice. Moreover,
the ratio of poorly functioning small surfactant aggregates to
superior functioning large aggregates isolated from alveolar wash
samples correlated with the physiologic responses. The calculated
contribution of secreted endogenous surfactant to the total alveolar
phospholipid pool at sacrifice was significantly greater for the
aerosolized Survanta group compared to the aerosolized BLES group.
This finding suggested that there were differences in the interaction
of the exogenous surfactants and their alveolar environments. We
conclude that the response to exogenous surfactant in acute lung
injury depends not only on the preparation used, but also on how the
surfactants are delivered to the injured lung.
Received 6 July 1995; accepted in final form 13 November 1995.
APS Manuscript Number A720-5.
Article publication pending Journal of Applied Physiology.
ISSN 1080-4757 Copyright 1995 The American Physiological Society.
Published in APStracts on 8 December 95