Lewis J, McCaig L, Häfner D, Spragg R, Veldhuizen R, Kerr C
Department of Medicine, Lawson Research Institute, London, Ontario, Canada.
Am J Respir Crit Care Med. 1999 Mar;159(3):741-7. doi: 10.1164/ajrccm.159.3.9806069.
The purpose of this study was to evaluate a surfactant based on a recombinant surfactant protein-C (rSP-C) at three different doses (25, 100, and 200 mg lipid/kg) in the saline lavage adult sheep model of acute lung injury. All three doses resulted in significant improvements in gas exchange, although the 100 and 200 mg/kg doses were superior to the 25 mg/kg dose. There were no significant differences in effect of the 100 and 200 mg/kg doses. In addition, the physiologic efficacy and lobar surfactant distribution patterns were similar when two different surfactant delivery methods were compared. This comparison involved administering the surfactant directly into each lobe under bronchoscopic guidance, versus instilling the surfactant through an endotracheal tube into the lungs. However, the former technique took significantly longer to perform (24.5 +/- 3.3 min versus 11.6 +/- 2.5 min, p < 0.05) and required a skilled bronchoscopist. In conclusion, rSP-C surfactant was effective in improving gas exchange in this model of lung injury, although higher doses were required for optimal responses. The bronchoscopic administration technique produced results similar to those of the tracheal instillation method, but had some disadvantages that may limit the widespread clinical use of this technique in patients with lung injury.
本研究的目的是在急性肺损伤的生理盐水灌洗成年绵羊模型中，评估基于重组表面活性蛋白-C（rSP-C）的表面活性剂在三种不同剂量（25、100和200mg脂质/kg）下的效果。所有三种剂量均使气体交换有显著改善，尽管100mg/kg和200mg/kg剂量优于25mg/kg剂量。100mg/kg和200mg/kg剂量的效果无显著差异。此外，比较两种不同的表面活性剂给药方法时，生理疗效和肺叶表面活性剂分布模式相似。这种比较包括在支气管镜引导下将表面活性剂直接注入每个肺叶，与通过气管内导管将表面活性剂滴入肺内。然而，前一种技术的操作时间明显更长（24.5±3.3分钟对11.6±2.5分钟，p<0.05），并且需要熟练的支气管镜检查医师。总之，rSP-C表面活性剂在该肺损伤模型中能有效改善气体交换，尽管需要更高剂量才能获得最佳反应。支气管镜给药技术产生的结果与气管内滴注法相似，但有一些缺点，可能会限制该技术在肺损伤患者中的广泛临床应用。
