Gilliard N, Richman P M, Merritt T A, Spragg R G
Department of Medicine, University of California, San Diego.
Am Rev Respir Dis. 1990 Mar;141(3):743-7. doi: 10.1164/ajrccm/141.3.743.
Administration of exogenous lung surfactant to infants with or at risk for respiratory distress syndrome has been demonstrated to improve gas exchange and survival; administration of surfactant to patients with the adult respiratory distress syndrome is currently undergoing clinical evaluation. Although it is currently assumed the optimal effect will occur when administered surfactant is distributed homogeneously throughout the lung, little is known of the influence of variables inherent in the administration procedure on subsequent distribution. To address this question, we studied the effect of the volume size in which the surfactant is suspended for instillation, and demonstrated a marked relationship in the normal rabbit lung between this volume and the subsequent homogeneity of surfactant distribution. In the rabbit lung that was acutely injured by oleic acid, this relationship was not evident. Concentration of administered surfactant was not demonstrated to be of major influence on its distribution after administration. Our results focus attention on the importance of parameters of the administration procedure, and also demonstrate the usefulness of the techniques used for determination of surfactant distribution.
已证明给患有呼吸窘迫综合征或有患呼吸窘迫综合征风险的婴儿使用外源性肺表面活性物质可改善气体交换并提高存活率；目前正在对给成人呼吸窘迫综合征患者使用表面活性物质进行临床评估。尽管目前认为当所给表面活性物质在肺内均匀分布时会产生最佳效果，但对于给药过程中固有变量对后续分布的影响知之甚少。为解决这个问题，我们研究了用于滴注的表面活性物质悬浮液的体积大小的影响，并证明在正常兔肺中该体积与表面活性物质分布的后续均匀性之间存在显著关系。在因油酸而急性损伤的兔肺中，这种关系并不明显。给药后，所给表面活性物质的浓度对其分布未显示出主要影响。我们的结果将注意力集中在给药过程参数的重要性上，同时也证明了用于确定表面活性物质分布的技术的有用性。
