Skip Navigation

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (7)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Hartog, A.
Right arrow Articles by Lachmann, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hartog, A.
Right arrow Articles by Lachmann, B.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

British Journal of Anaesthesia, 2000, Vol. 85, No. 5 752-756
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Improvement of lung mechanics by exogenous surfactant: effect of prior application of high positive end-expiratory pressure

A. Hartog, D. Gommers, J. J. Haitsma and B. Lachmann*

Department of Anaesthesiology, Erasmus University Rotterdam, Rotterdam, The Netherlands

The use of a ventilation strategy with high positive end-expiratory pressure (PEEP) that is intended to recruit collapsed alveoli and to prevent recurrent collapse can reduce alveolar protein influx in experimental acute lung injury (ALI). This could affect the pulmonary response to treatment with surfactant, since plasma proteins inhibit surfactant function. We studied the effect of exogenous surfactant on lung mechanics after 4 h of mechanical ventilation with high or low PEEP. Twenty-two adult male Sprague–Dawley rats were anaesthetized, tracheotomized and submitted to pressure-controlled mechanical ventilation with 100% oxygen. One group served as healthy controls (n=6). In the remaining animals acute lung injury was induced by repeated lung lavages to obtain a PaO2<13 kPa during ventilation with a peak inspiratory pressure (PIP) of 26 cm H2O and a PEEP of 6 cm H2O. These animals were allocated randomly to ventilation with high PEEP (n=8; 100 breaths min–1, I:E=1:1, PIP 35 cm H2O, PEEP 18 cm H2O) or to conventional mechanical ventilation (PIP 28 cm H2O, PEEP 8 cm H2O; n=8; ventilated control group). After 4 h of ventilation, all animals were given surfactant (120 mg kg–1) via the trachea and ventilation was continued for 15 min. At the end of the study, pressure–volume curves were constructed to measure total lung capacity at 35 cm H2O (TLC35) and maximal compliance (Cmax), and bronchoalveolar lavage was then used to measure alveolar protein influx. After lavage, PaO2 remained around 13 kPa in the ventilated control group and was >66 kPa in the high-PEEP group. After surfactant treatment, PaO2 increased to >53 kPa in both groups. In the ventilated control group alveolar protein influx was greater and TLC35 and Cmax were lower than in the high-PEEP group. We conclude that the pulmonary response to exogenous surfactant after mechanical ventilation in experimental ALI is improved when a ventilation strategy with high PEEP is used.

Br J Anaesth 2000; 85: 752–6

* Corresponding author: Department of Anaesthesiology (Room Ee 2393), Erasmus University Rotterdam, Post Box 1738, 3000 DR Rotterdam, The Netherlands


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 PediatricsHome page
T. A. Leone, W. Rich, and N. N. Finer
A Survey of Delivery Room Resuscitation Practices in the United States
Pediatrics, February 1, 2006; 117(2): e164 - e175.
[Abstract] [Full Text] [PDF]

Home page
 NeoReviewsHome page
T. A. Leone and N. N. Finer
Neonatal Resuscitation: Beyond the Basics
NeoReviews, April 1, 2005; 6(4): e177 - e183.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.