Aerosolized KL4 surfactant improves short‐term survival and gas exchange in spontaneously breathing newborn pigs with hydrochloric acid‐induced acute lung injury. Issue 5 (3rd September 2013)

• Record Type: Journal Article
• Authors: Lampland, Andrea L.; Wolfson, Marla R.; Mazela, Jan; Henderson, Christopher; Gregory, Timothy J.; Meyers, Patricia; Plumm, Brenda; Worwa, Cathy; Mammel, Mark C.
• Is Part Of: Pediatric pulmonology. Volume 49:Issue 5(2014:May)
• Page Start: 482
• Page End: 489
• Publication Date: 2013-09-03
• Subjects: Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.22844
• Languages: English
• ISSNs: 8755-6863

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Summary</title> <sec id="ppul22844-sec-0001" sec-type="section"> <title>Background</title> <p>Surfactant therapy may be beneficial in acute lung injury (ALI). In spontaneously breathing newborn pigs with ALI supported with continuous positive airway pressure (CPAP), we evaluated the hypothesis that aerosolized KL<sub>4</sub> surfactant (AERO KL<sub>4</sub>S) would provide a similar therapeutic effect as intratracheal KL<sub>4</sub> surfactant (ETT KL<sub>4</sub>S) when compared to controls.</p> </sec> <sec id="ppul22844-sec-0002" sec-type="section"> <title>Methods</title> <p>We randomized pigs with HCl‐induced ALI to: (1) 175 mg/kg KL<sub>4</sub> surfactant via endotracheal tube (ETT); (2) AERO KL<sub>4</sub>S (22.5 mg/min phospholipid) for 60 min via continuous positive airway pressure (CPAP); or (3) sham procedure on CPAP. We obtained physiologic data and arterial blood gases throughout the 3‐hr study. At study end, lungs were excised for analysis of interleukin‐8 (IL‐8), myeloperoxidase (MPO) levels and histomorphometric data.</p> </sec> <sec id="ppul22844-sec-0003" sec-type="section"> <title>Results</title> <p>Pigs treated with ETT KL<sub>4</sub>S and AERO KL<sub>4</sub>S had improved survival and sustained pO<sub>2</sub> compared to controls. The AERO KL<sub>4</sub>S group had higher pH compared to controls. Lung IL‐8 levels were lower in the AERO KL<sub>4</sub>S group compared to controls. Histomorphometric analysis showed less hemorrhage in the ETT and AERO KL<sub>4</sub>S groups compared to controls. The AERO KL<sub>4</sub>S group had more open lung units per fixed‐field than the ETT KL<sub>4</sub>S or controls.</p> </sec> <sec id="ppul22844-sec-0004" sec-type="section"> <title>Conclusions</title> <p>AERO KL<sub>4</sub>S produced similar improvements in survival, physiology, inflammatory markers, and morphology as ETT KL<sub>4</sub>S in an ALI model. <bold>Pediatr Pulmonol. 2014; 49:482–489.</bold> © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>