Abstract
Background: Partial liquid ventilation (PLV) represents an alternative therapy of severe respiratory insufficiency, caused by disturbances of the pulmonary surfactant. To wean patients from PLV an intact surfactant system is required. Data concerning the interaction of perfluorocarbons (PFC) with surfactant metabolism are controversial. According to in vitro data we hypothesized that intracellular surfactant pool is reduced in PLV treated animals.
Methods: Prospective, randomized animal study on male wistar rats. Surfactant depleted rats were treated with either PLV (Lavaged-PFC, n=5) or conventional mechanical ventilation (Lavaged-Air, n=5) for 1 hour. For control, 10 healthy animals with air (Healthy-Air, n=5) or PFC filled lungs (Healthy-PFC, n=5) were studied. A design-based stereological approach was used for quantification of lung parenchyma and the intracellular and intraalveolar surfactant pool at the light and electron microscopic level.
Results: Compared to Healthy-lungs, Lavaged-animals had more type II cells with lamellar bodies in the process of secretion and freshly secreted lamellar body like surfactant in the alveoli. Fraction of surfactant covered alveolar epithelial surface area and total intraalveolar surfactant content were significantly smaller in Lavaged-animals. Compared with Air-filled lungs, both PFC-groups had a significantly higher total lung volume, but no other differences.
Conclusion: In contrast to the hypothesis, short term PLV in surfactant depleted animals neither affects the intracellular and intraalveolar surfactant composition nor the surfactant content.
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Rüdiger, M., Wendt, S., Köthe, L. et al. 229 Effect of Perfluorocarbon on Pulmonary Surfactant. An Electron Microscopical and Stereological Study. Pediatr Res 56, 503 (2004). https://doi.org/10.1203/00006450-200409000-00252
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DOI: https://doi.org/10.1203/00006450-200409000-00252