Am. J. Respir. Crit. Care Med., Vol 152, No. 2, Aug 1995, 597-602.
Comparison of exogenous surfactants in the treatment of wood smoke inhalation
GF Nieman, AM Paskanik, RR Fluck and WR Clark
Department of Surgery, State University of New York Health Science Center, Syracuse 13210, USA.
The goal of this study was to compare the effectiveness of the exogenous
surfactants Infasurf and Exosurf in reestablishing surfactant function
inhibited by severe smoke inhalation. Mongrel dogs (n = 17) were
anesthetized, placed on a ventilator (40% O2), and surgically prepared for
hemodynamic and blood gas measurements; venous admixture (QVA/QT) and
static lung compliance (Cstat) were calculated. At the conclusion of the
experiment, lung samples were taken for lung water and dynamic surface
tension (DST, Wilhelmy balance) measurements. Following baseline
measurements, dogs were randomly separated into four groups: Group I,
smoke+sham instillation; Group II, smoke+saline instillation: Group III,
smoke+Exosurf instillation; and Group IV, smoke+Infasurf instillation. The
surfactants (Infasurf and Exosurf, 100 mg/kg) or saline (same volume as
surfactants) were instilled into the lungs via suction catheter immediately
following smoke exposure. Smoke inhalation caused a similar increase in
QVA/QT and fall in PaO2 and Cstat in all groups that improved only with
Infasurf instillation (Group IV). DST was significantly improved by
Infasurf compared with all other groups. We conclude that Infasurf restores
normal DST, inhibited by wood smoke, improving lung function. Exosurf was
ineffective in the treatment of wood smoke inhalation.
