Efficacy of Surfactant Therapy of ARDS Induced by Hydrochloric Acid Aspiration Followed by Ventilator-Induced Lung Injury – an Animal Study

The development of acute respiratory distress syndrome (ARDS) is known to be independently attributable to aspiration-induced lung injury. Mechanical ventilation as a high pressure/volume support to maintain sufficient oxygenation of a patient could initiate ventilator-induced lung injury (VILI) and...

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Published in:Physiological research 2022-12, Vol.71 (Suppl. 2), p.S237-S249
Main Authors: MIKOLKA, P, KOSUTOVA, P, KOLOMAZNIK, M, MATEFFY, S, NEMCOVA, N, MOKRA, D, CALKOVSKA, A
Format: Article
Language:English
Subjects:
Alveoli
Animal models
Animals
Edema
Hydrochloric acid
Inflammation
Lungs
Mechanical ventilation
Mortality
Phospholipids
Proteins
Recovery of function
Respiratory distress syndrome
Respiratory failure
Respiratory function
Surfactants
Trachea
Ventilators
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container_title Physiological research
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description The development of acute respiratory distress syndrome (ARDS) is known to be independently attributable to aspiration-induced lung injury. Mechanical ventilation as a high pressure/volume support to maintain sufficient oxygenation of a patient could initiate ventilator-induced lung injury (VILI) and thus contribute to lung damage. Although these phenomena are rare in the clinic, they could serve as the severe experimental model of alveolar-capillary membrane deterioration. Lung collapse, diffuse inflammation, alveolar epithelial and endothelial damage, leakage of fluid into the alveoli, and subsequent inactivation of pulmonary surfactant, leading to respiratory failure. Therefore, exogenous surfactant could be considered as a therapy to restore lung function in experimental ARDS. This study aimed to investigate the effect of modified porcine surfactant in animal model of severe ARDS (P/F ratio ≤13.3 kPa) induced by intratracheal instillation of hydrochloric acid (HCl, 3 ml/kg, pH 1.25) followed by VILI (VT 20 ml/kg). Adult rabbits were divided into three groups: untreated ARDS, model treated with a bolus of poractant alfa (Curosurf®, 2.5 ml/kg, 80 mg phospholipids/ml), and healthy ventilated animals (saline), which were oxygen-ventilated for an additional 4 h. The lung function parameters, histological appearance, degree of lung edema and levels of inflammatory and oxidative markers in plasma were evaluated. Whereas surfactant therapy with poractant alfa improved lung function, attenuated inflammation and lung edema, and partially regenerated significant changes in lung architecture compared to untreated controls. This study indicates a potential of exogenous surfactant preparation in the treatment of experimental ARDS.
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source Open Access: PubMed Central
subjects Alveoli
Animal models
Animals
Edema
Hydrochloric acid
Inflammation
Lungs
Mechanical ventilation
Mortality
Phospholipids
Proteins
Recovery of function
Respiratory distress syndrome
Respiratory failure
Respiratory function
Surfactants
Trachea
Ventilators
title Efficacy of Surfactant Therapy of ARDS Induced by Hydrochloric Acid Aspiration Followed by Ventilator-Induced Lung Injury – an Animal Study
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