Aerosolized KL4 surfactant improves short-term survival and gas exchange in spontaneously breathing newborn pigs with hydrochloric acid-induced acute lung injury

Andrea L. Lampland, Marla R. Wolfson, Jan Mazela, Christopher Henderson, Timothy J. Gregory, Patricia Meyers, Brenda Plumm, Cathy Worwa, Mark C Mammel

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22 Scopus citations

Abstract

Summary Background Surfactant therapy may be beneficial in acute lung injury (ALI). In spontaneously breathing newborn pigs with ALI supported with continuous positive airway pressure (CPAP), we evaluated the hypothesis that aerosolized KL4 surfactant (AERO KL4S) would provide a similar therapeutic effect as intratracheal KL4 surfactant (ETT KL4S) when compared to controls. Methods We randomized pigs with HCl-induced ALI to: (1) 175mg/kg KL4 surfactant via endotracheal tube (ETT); (2) AERO KL4S (22.5mg/min phospholipid) for 60min via continuous positive airway pressure (CPAP); or (3) sham procedure on CPAP. We obtained physiologic data and arterial blood gases throughout the 3-hr study. At study end, lungs were excised for analysis of interleukin-8 (IL-8), myeloperoxidase (MPO) levels and histomorphometric data. Results Pigs treated with ETT KL4S and AERO KL4S had improved survival and sustained pO2 compared to controls. The AERO KL4S group had higher pH compared to controls. Lung IL-8 levels were lower in the AERO KL4S group compared to controls. Histomorphometric analysis showed less hemorrhage in the ETT and AERO KL4S groups compared to controls. The AERO KL4S group had more open lung units per fixed-field than the ETT KL4S or controls. Conclusions AERO KL4S produced similar improvements in survival, physiology, inflammatory markers, and morphology as ETT KL4S in an ALI model.

Original languageEnglish (US)
Pages (from-to)482-489
Number of pages8
JournalPediatric pulmonology
Volume49
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • CPAP
  • acute lung injury
  • aerosol
  • surfactant

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