Am. J. Respir. Crit. Care Med.,
Volume 164, Number 8, October 2001, 1531-1536
Polyethylene Glycol/Surfactant Mixtures Improve Lung
Function after HCl and Endotoxin Lung Injuries
KAREN W.
LU,
H. WILLIAM
TAEUSCH,
BENGT
ROBERTSON,
JON
GOERKE,
and
JOHN A.
CLEMENTS
Department of Pediatrics and Physiology, and the Cardiovascular Research Institute, University of California-San Francisco, San Francisco,
California; and Department of Women and Child Health, Karolinska Institute, Stockholm, Sweden
Addition of nonionic polymers such as polyethylene glycol (PEG)
and dextran ameliorates inactivation of Survanta by a variety of
substances in vitro. Addition of polymers to Survanta also improves pulmonary function when used to treat rats with lung injury caused by instillation of human meconium. To find whether this approach is effective in lung injuries that more closely resemble adult respiratory distress syndrome (ARDS), we have compared the use of Survanta with Survanta + PEG in two additional
models of lung injury caused by either lipopolysaccharide (LPS) or
HCl in adult rats. Significant improvement of serial measures for arterial oxygenation and of postmortem pressure-volume measurements were found after treatment with Survanta + PEG compared with Survanta alone. PEG added to Survanta increased resistance to inactivation caused by tracheal fluid taken from animals
injured with HCl. Other work suggests that PEG promotes surfactant aggregation, separates surfactant from surfactant inhibitors,
and enhances access of surfactant to the gas-liquid interface. The
addition of polymers to surfactants may also be useful in the treatment of lung injury where inactivation of surfactant has already occurred.
