SURFACTANT TREATMENT FOR VENTILATION-INDUCED LUNG INJURY IN RATS: EFFECTS ON LUNG COMPLIANCE AND CYTOKINES

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Abstract
The objective of this study was to determine if exogenous surfactant therapy could prevent the harmful effects ofventilation at high tidal volumes without positive end-expiratory pressure (PEEP). Rats were randomized to either a nontreated controlgroup (8mL/kg 4cm H 2 O PEEP), a nontreated injuriously ventilated group (20mL/kg 0cm H 2 O PEEP)or a treatment group of either 50 mg/kg, 50 mg/kg + 5% surfactant-associated protein A, or 100 mg/kg exogenous surfactant followed by injurious ventilation. Isolated lungs from animals in all 5 groups were ventilated in a humidified box at 37° C for 2 hours. Pressure-volume curves and light microscopy showed that surfactant treatment reduced the ventilation-induced lung injury (VILI). Inflammatory cytokines (tumor necrosis factor- α [TNF α ], interleukin [IL]-1 β, and IL-6) in the lavage were significantly higher in injuriously ventilated lungs compared to the control group. However, the 3 treatment groups had cytokine concentrations that were similar to the injuriously ventilated group. Weconclude that surfactant treatment is beneficial in preventing VILI; however, it does not prevent the release of inflammatory cytokines during mechanical ventilation.

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