1992 Fiscal Year Final Research Report Summary
Surfactant supplement for adult respiratory distress
| Project/Area Number |
02454352
|
|---|
| Research Category |
Grant-in-Aid for General Scientific Research (B)
|
| Allocation Type | Single-year Grants |
|---|
| Research Field |
麻酔学
|
|---|
| Research Institution | Kanazawa University |
|---|
Principal Investigator |
KOBAYASHI Tsutomu School of Med. Anesthe: Associate Prof., 医学部, 助教授 (40019922)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
TANIGUCHI J Kanazawa Univ. Hospital: Anesthesiology: Instructor, 医学部・附属病院, 助手 (30227219)
|
|---|
| Project Period (FY) |
1990 – 1992
|
| Keywords | ARDS / Surfactant / Respiratory Failure / Lung Edema / Supplement / Lung Compliance / Hypoxemia |
|---|
| Research Abstract |
Pathological process of adult respiratory distress syndrome (ARDS) is largely unknown with 50-70% mortality.
(1) Investigation on the pathological process: An exogenous surfactant was mixed with lung edema fluid sampled from ARDS patients, and administered to the lungs of immature newborn rabbits. When the edema fluid protein-to-surfactant ratio increased from 5.6 to 11.2, the dynamic lung compliance of the animals decreased from 1.08 (mean) to 0.43 ml/cmH_2O/kg (P < 0.05). We conclude that a cause of respiratory failure in ARDS is inactivation of pulmonary surfactant by lung edema that appears during the course.
(2) Treatment of ARDS by surfactant supplement: Respiratory failure induced by administration of E. Coli endotoxin in rats was largely reversed by supplementation of an exogenous surfactant (100 mg/kg); PaO_2 improved from 106 mmHg (mean) to above 400 mmHg (P < 0.05), and diffuse infiltrates in the chest radiogram disappeared. We conclude that surfactant supplementation can reverse the respiratory failure in ARDS.
(3) Artificial surfactant for the supplement therapy: Dipalmitoyl lecithin, unsaturated lecithin (u-L), phosphatidylglycerol and the hydrophobic proteins of porcine surfactant were mixed with various ratios. Dynamic lung compliance of the immature newborn rabbits receiving the mixture consists of all the components was 1.24 ml/cmH_2O/kg (mean), but the value receiving the mixture without u-L was 0.79 ml/cmH_2O/kg (P < 0.05). We conclude that u-L is an important factor for surfactant activity.
|
