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Am. J. Respir. Crit. Care Med., Volume 156, Number 3, September 1997, 862-866

Effect of Volume Recruitment on Response to Surfactant Treatment in Rabbits with Lung Injury

MARTIN KRAUSE, TORSTEN OLSSON, AMY B. LAW, ROBERT A. PARKER, DANIEL P. LINDSTROM, HÅKAN W. SUNDELL, and ROBERT B. COTTON

Departments of Pediatrics and Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; and Department of Applied Electronics, Chalmers University of Technology, Göteborg, Sweden

We determined if surfactant treatment effect can be enhanced by mechanical volume recruitment during surfactant administration by measuring functional residual capacity, tidal volume, the alveolar portion of tidal volume, dynamic compliance of the respiratory system, a/A ratio, and PaCO2 by measuring before and after surfactant administration to rabbits with lung injury induced by airway lavage. There was improvement in all lung function indices when surfactant was given with volume recruitment, but when surfactant was given without volume recruitment, the only index to show significant improvement was a/A ratio of oxygenation. These results support the hypothesis that mechanical recruitment of terminal airspaces from a previously unventilated compartment will enhance the effectiveness of surfactant replacement by facilitating the distribution of instilled surfactant to this compartment.




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