Heikamp, A

Oetomo, SB

The purpose of this study was to evaluate whether avoiding interruption of ventilation during surfactant instillation improves the effects on lung function and surfactant distribution and whether it prevents the adverse effects on blood pressure and cerebral blood flow. The study was performed using rabbits with severe respiratory failure induced by lung lavages. These rabbits were randomized to Tc-99m-Nanocoll labeled surfactant instillation through a side lumen of the endotracheal tube without interrupting ventilation or instillation during a short interruption of ventilation. After surfactant instillation with interruption of ventilation, Pao, rose from 8.7 +/- 1.3 to 24.9 +/- 6.4 kPa (mean +/- SEM). Without interruption, Pao, rose from 8.4 +/- 0.8 to 32.4 +/- 4.3 kPa, Pace, decreased with interruption from 4.69 +/- 0.51 to 3.61 +/- 0.26 kPa and without interruption from 5.06 +/- 0.41 to 4.13 +/- 0.23 kPa. Dynamic and static compliance indites were not statistically different after both procedures. Surfactant distribution tended to be less nonuniform after instillation without interrupting ventilation. In contrast, avoidance of interruption of ventilation resulted in less uniform lobar distribution and less peripheral deposition of surfactant. By instillation with interruption, blood pressure increased quickly (28 +/- 6.6%), followed by a 22 +/- 5.3% decrease. Blood pressure increased quickly (16 +/- 4.2%), followed by a 40 +/- 10% decrease by surfactant instillation without interruption. Cerebral blood flow, measured by an ultrasonic transit time flow probe on the carotid artery, increased quickly (45 +/- 14%), followed by a 64 +/- 11% decrease with interruption, whereas it increased 15 +/- 4.9% (p = 0.06 versus with interruption) and decreased 61 +/- 13% without interruption of ventilation. Therefore, avoiding interruption of ventilation during surfactant instillation tends to prevent the potential adverse effects of a rapid rise in cerebral blood flow, and furthermore, tends to improve uniformity of surfactant distribution, whereas having no detrimental effect on respiratory function.</p

Dissertations of the University of Groningen

A comparison of the hemodynamic and respiratory effects of surfactant instillation during interrupted ventilation versus noninterrupted ventilation in rabbits with severe respiratory failure

A comparison of the hemodynamic and respiratory effects of surfactant instillation during interrupted ventilation versus noninterrupted ventilation in rabbits with severe respiratory failure

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Dissertations of the University of Groningen