Effect of Surfactant and Partial Liquid Ventilation Treatment on Gas Exchange and Lung Mechanics in Immature Lambs: Influence of Gestational Age |
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Authors: | Carmen Rey-Santano Victoria Mielgo Elena Gastiasoro Adolfo Valls-i-Soler Xabier Murgia |
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Affiliation: | 1. Research Unit for Experimental Neonatal Respiratory Physiology, Cruces University Hospital, Barakaldo, Bizkaia, Spain.; 2. Neonatal Intensive Care Unit, Cruces University Hospital, Barakaldo, Bizkaia, Spain.; University of Giessen Lung Center, Germany, |
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Abstract: | ObjectivesSurfactant (SF) and partial liquid ventilation (PLV) improve gas exchange and lung mechanics in neonatal RDS. However, variations in the effects of SF and PLV with degree of lung immaturity have not been thoroughly explored.SettingExperimental Neonatal Respiratory Physiology Research Unit, Cruces University Hospital.DesignProspective, randomized study using sealed envelopes.Subjects36 preterm lambs were exposed (at 125 or 133-days of gestational age) by laparotomy and intubated. Catheters were placed in the jugular vein and carotid artery.InterventionsAll the lambs were assigned to one of three subgroups given: 20 mL/Kg perfluorocarbon and managed with partial liquid ventilation (PLV), surfactant (Curosurf®, 200 mg/kg) or (3) no pulmonary treatment (Controls) for 3 h.Measurements and Main ResultsCardiovascular parameters, blood gases and pulmonary mechanics were measured. In 125-day gestation lambs, SF treatment partially improved gas exchange and lung mechanics, while PLV produced significant rapid improvements in these parameters. In 133-day lambs, treatments with SF or PLV achieved similarly good responses. Neither surfactant nor PLV significantly affected the cardiovascular parameters.ConclusionSF therapy response was more effective in the older gestational age group whereas the effectiveness of PLV therapy was not gestational age dependent. |
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