Ohama Y, Itakura Y, Koyama N, Eguchi H, Ogawa Y
Department of Pediatrics, Saitama Medical Center, Saitama Medical School, Japan.
Acta Paediatr Jpn. 1994 Jun;36(3):236-8. doi: 10.1111/j.1442-200x.1994.tb03170.x.
Meconium aspiration syndrome (MAS) is a frequent cause of respiratory distress in neonates. Recent reports have suggested that surfactant dysfunction contributes to the pathophysiology of MAS and surfactant therapy improves oxygenation of infants with MAS. We evaluated the effect of bronchial lavage with surfactant solution in a rabbit model of meconium aspiration. All animals were given 5 mL/kg of a 20% slurry of human meconium into the endotracheal tube and mechanically ventilated. The animals were then divided into saline lavage (n = 5) or surfactant lavage (n = 5). Lavage was performed an hour after meconium instillation. After the lavage the total amount of meconium recovered was measured. Blood gas was monitored during the experiment. The amount of meconium recovered by saline lavage was 14%, and by surfactant lavage was 57%. The surfactant group had a significant improvement in gas exchange, whereas the saline group had no improvement. It was concluded that the lavage with surfactant solution effectively washed out meconium and improved gas exchange in rabbit model of MAS.
胎粪吸入综合征（MAS）是新生儿呼吸窘迫的常见原因。最近的报告表明，表面活性剂功能障碍促成了MAS的病理生理学，且表面活性剂疗法可改善MAS患儿的氧合。我们在胎粪吸入的兔模型中评估了用表面活性剂溶液进行支气管灌洗的效果。所有动物经气管内导管给予5 mL/kg的20%人胎粪混悬液并进行机械通气。然后将动物分为盐水灌洗组（n = 5）或表面活性剂灌洗组（n = 5）。在滴入胎粪1小时后进行灌洗。灌洗后测量回收的胎粪总量。实验期间监测血气。盐水灌洗回收的胎粪量为14%，表面活性剂灌洗回收的胎粪量为57%。表面活性剂组的气体交换有显著改善，而盐水组则无改善。得出的结论是，在MAS兔模型中，用表面活性剂溶液灌洗可有效清除胎粪并改善气体交换。
