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Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS

BACKGROUND: Several concepts of treatment in neonatal ARDS have been proposed in the last years. The present study compared the effects of open lung concept positive pressure ventilation (PPV(OLC)) with a conventional ventilation strategy combined with administration of two different surfactant prep...

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Autores principales: Hilgendorff, Anne, Aslan, Ece, Schaible, Thomas, Gortner, Ludwig, Baehner, Thorsten, Ebsen, Michael, Kreuder, Jochen, Ruppert, Clemens, Guenther, Andreas, Reiss, Irwin
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483254/
https://www.ncbi.nlm.nih.gov/pubmed/18625067
http://dx.doi.org/10.1186/1471-2466-8-10
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author Hilgendorff, Anne
Aslan, Ece
Schaible, Thomas
Gortner, Ludwig
Baehner, Thorsten
Ebsen, Michael
Kreuder, Jochen
Ruppert, Clemens
Guenther, Andreas
Reiss, Irwin
author_facet Hilgendorff, Anne
Aslan, Ece
Schaible, Thomas
Gortner, Ludwig
Baehner, Thorsten
Ebsen, Michael
Kreuder, Jochen
Ruppert, Clemens
Guenther, Andreas
Reiss, Irwin
author_sort Hilgendorff, Anne
collection PubMed
description BACKGROUND: Several concepts of treatment in neonatal ARDS have been proposed in the last years. The present study compared the effects of open lung concept positive pressure ventilation (PPV(OLC)) with a conventional ventilation strategy combined with administration of two different surfactant preparations on lung function and surfactant homoeostasis. METHODS: After repeated whole-lung saline lavage, 16 newborn piglets were assigned to either PPV(OLC )(n = 5) or surfactant treatment under conventional PPV using a natural bovine (n = 5) or a monomeric protein B based surfactant (n = 6). RESULTS: Comprehensive monitoring showed each treatment strategy to improve gas exchange and lung function, although the effect on Pa(O2 )and pulmonary compliance declined over the study period in the surfactant groups. The overall improvement of the ventilation efficiency index (VEI) was significantly greater in the PPV(OLC )group. Phospholipid and protein analyses of the bronchoalveolar lavage fluid showed significant alterations to surfactant homoeostasis in the PPV(OLC )group, whereas IL-10 and SP-C mRNA expression was tendentially increased in the surfactant groups. CONCLUSION: The different treatment strategies applied could be shown to improve gas exchange and lung function in neonatal ARDS. To which extent differences in maintenance of lung function and surfactant homeostasis may lead to long-term consequences needs to be studied further.
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spelling pubmed-24832542008-07-24 Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS Hilgendorff, Anne Aslan, Ece Schaible, Thomas Gortner, Ludwig Baehner, Thorsten Ebsen, Michael Kreuder, Jochen Ruppert, Clemens Guenther, Andreas Reiss, Irwin BMC Pulm Med Research Article BACKGROUND: Several concepts of treatment in neonatal ARDS have been proposed in the last years. The present study compared the effects of open lung concept positive pressure ventilation (PPV(OLC)) with a conventional ventilation strategy combined with administration of two different surfactant preparations on lung function and surfactant homoeostasis. METHODS: After repeated whole-lung saline lavage, 16 newborn piglets were assigned to either PPV(OLC )(n = 5) or surfactant treatment under conventional PPV using a natural bovine (n = 5) or a monomeric protein B based surfactant (n = 6). RESULTS: Comprehensive monitoring showed each treatment strategy to improve gas exchange and lung function, although the effect on Pa(O2 )and pulmonary compliance declined over the study period in the surfactant groups. The overall improvement of the ventilation efficiency index (VEI) was significantly greater in the PPV(OLC )group. Phospholipid and protein analyses of the bronchoalveolar lavage fluid showed significant alterations to surfactant homoeostasis in the PPV(OLC )group, whereas IL-10 and SP-C mRNA expression was tendentially increased in the surfactant groups. CONCLUSION: The different treatment strategies applied could be shown to improve gas exchange and lung function in neonatal ARDS. To which extent differences in maintenance of lung function and surfactant homeostasis may lead to long-term consequences needs to be studied further. BioMed Central 2008-07-14 /pmc/articles/PMC2483254/ /pubmed/18625067 http://dx.doi.org/10.1186/1471-2466-8-10 Text en Copyright © 2008 Hilgendorff et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hilgendorff, Anne
Aslan, Ece
Schaible, Thomas
Gortner, Ludwig
Baehner, Thorsten
Ebsen, Michael
Kreuder, Jochen
Ruppert, Clemens
Guenther, Andreas
Reiss, Irwin
Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS
title Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS
title_full Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS
title_fullStr Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS
title_full_unstemmed Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS
title_short Surfactant replacement and open lung concept – Comparison of two treatment strategies in an experimental model of neonatal ARDS
title_sort surfactant replacement and open lung concept – comparison of two treatment strategies in an experimental model of neonatal ards
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483254/
https://www.ncbi.nlm.nih.gov/pubmed/18625067
http://dx.doi.org/10.1186/1471-2466-8-10
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