Bronchoalveolar lavage plus surfactant in a piglet model of meconium aspiration syndrome

• Published in: Neonatology (Basel, Switzerland) Vol. 93; no. 3; p. 188
• Main Authors: Colvero, Mauricio Obal, Fiori, Humberto Holmer, Fiori, Renato Machado, Luz, Jorge Hecker, de Paula, Davi, Oppermann, Christina, Pitrez, Paulo Márcio, da Silva, Vinícius Duval, Colvero, Aline Pieruccini
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2008
• Subjects: Animals; Animals, Newborn; Blood Gas Analysis; Bronchoalveolar Lavage - methods; Disease Models, Animal; Histocytochemistry; Humans; Infant, Newborn; Meconium Aspiration Syndrome - pathology; Meconium Aspiration Syndrome - therapy; Pulmonary Surfactants - therapeutic use; Random Allocation; Swine
• ISSN: 1661-7819
• DOI: 10.1159/000110866

Meconium aspiration produces airway obstruction and surfactant inhibition. Bronchoalveolar lavage (BAL) and surfactant replacement have been proposed as treatments for the syndrome.
To evaluate the effect of BAL with normal saline followed by a supplementary dose of surfactant in a piglet model of meconium aspiration syndrome.
15 newborn piglets were used in the study. The animals were ventilated with fixed settings. After inhalation of 4 ml/kg of diluted meconium, the piglets were randomized into three groups: group I (n = 5) - tracheal aspiration without BAL; group II (n = 5) - BAL with normal saline (15 ml/kg), and group III (n = 5) - BAL with normal saline (15 ml/kg) followed by a supplementary dose of surfactant (Curosurf(R) 100 mg/kg). Arterial blood gas samples were obtained 30 min and 6 h after the inhalation of meconium.
A significant increase of PaO(2 )values at 6 h after treatment was only observed in group III (from 51 +/- 13 to 189 +/- 115 mm Hg; p = 0.04). At this time, PaO(2) in group III was significantly higher compared to group II (189 +/- 115 and 37 +/- 11 mm Hg, respectively; p = 0.023) and showed a borderline significance when compared to group I (p = 0.066).
BAL with normal saline followed by a supplementary dose of surfactant may improve oxygenation in an experimental piglet model of meconium aspiration syndrome.