Bronchoalveolar Lavage plus Surfactant in a Piglet Model of Meconium Aspiration Syndrome

Introduction: Meconium aspiration produces airway obstruction and surfactant inhibition. Bronchoalveolar lavage (BAL) and surfactant replacement have been proposed as treatments for the syndrome. Objective: To evaluate the effect of BAL with normal saline followed by a supplementary dose of surfactant in a piglet model of meconium aspiration syndrome. Methods: 15 newborn piglets were used in the study. The animals were ventilated with fixed settings. After inhalation of 4 ml/kg of diluted meconium, the piglets were randomized into three groups: group I (n = 5) – tracheal aspiration without BAL; group II (n = 5) – BAL with normal saline (15 ml/kg), and group III (n = 5) – BAL with normal saline (15 ml/kg) followed by a supplementary dose of surfactant (Curosurf® 100 mg/kg). Arterial blood gas samples were obtained 30 min and 6 h after the inhalation of meconium. Results: A significant increase of PaO 2 values at 6 h after treatment was only observed in group III (from 51 ± 13 to 189 ± 115 mm Hg; p = 0.04). At this time, PaO 2 in group III was significantly higher compared to group II (189 ± 115 and 37 ± 11 mm Hg, respectively; p = 0.023) and showed a borderline significance when compared to group I (p = 0.066). Conclusion: BAL with normal saline followed by a supplementary dose of surfactant may improve oxygenation in an experimental piglet model of meconium aspiration syndrome.