Lawson Health Research Institute, University of Western Ontario, 268 Grosvenor Street, London, ON N6A4V2, Canada.
Can J Physiol Pharmacol. 2010 Jan;88(1):14-20. doi: 10.1139/Y09-096.
Both exogenous surfactant therapy and high-frequency oscillation (HFO) have been proposed as clinical interventions in acute respiratory distress syndrome (ARDS). The combination of these 2 interventions has not been studied in a relevant model of ARDS. It was hypothesized that surfactant treatment combined with HFO is superior to either surfactant treatment or HFO alone in a model of ARDS. Adult rats had lung injury induced by instillation of 0.1 mol/L HCl, followed by randomization to one of 4 groups: Conventional mechanical ventilation (CMV) + air (no treatment), CMV + surfactant, HFO + air, and HFO + surfactant. Oxygenation, lung compliance, surfactant, and cytokine concentrations in the lung lavage were analyzed. The results showed superior oxygenation in HFO ventilated animals regardless of surfactant treatment compared with CMV. Nonsurfactant-treated animals ventilated with HFO had a significantly greater proportion of large aggregates, and had greater lung compliance compared with non-surfactant-treated animals ventilated with CMV. Surfactant therapy combined with HFO provided no advantages with respect to these outcomes. These data suggest an advantage of HFO over CMV when exogenous surfactant was not given, and that surfactant treatment combined with HFO was not superior to HFO ventilation alone.
外源性表面活性剂治疗和高频振荡（HFO）都被提议作为急性呼吸窘迫综合征（ARDS）的临床干预措施。这两种干预措施的联合在相关的 ARDS 模型中尚未得到研究。假设在 ARDS 模型中，表面活性剂治疗联合 HFO 优于单独使用表面活性剂治疗或 HFO。成年大鼠通过滴注 0.1mol/L HCl 诱导肺损伤，然后随机分为 4 组之一：常规机械通气（CMV）+空气（无治疗）、CMV+表面活性剂、HFO+空气和 HFO+表面活性剂。分析了氧合、肺顺应性、表面活性剂和肺灌洗液中的细胞因子浓度。结果表明，与 CMV 相比，HFO 通气的动物无论表面活性剂治疗如何，其氧合均更好。与 CMV 通气的非表面活性剂治疗动物相比，用 HFO 通气的非表面活性剂治疗动物的大聚集体比例显著更高，肺顺应性也更高。表面活性剂联合 HFO 治疗在这些结果方面没有优势。这些数据表明，在外源性表面活性剂未给予时，HFO 优于 CMV，并且表面活性剂联合 HFO 治疗并不优于单独 HFO 通气。
