Immediate improvement in lung volume after exogenous surfactant: Alveolar recruitment versus increased distention
To determine whether changes in lung volume may be responsible for the clinical improvement in preterm infants given exogenous surfactant, we measured functional residual capacity (FRC), lung mechanics, and partial pressure of oxygen in seven ventilated neonates (birth weight 1080±361 gm (mean ± SD)...
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| Veröffentlicht in: | The Journal of pediatrics 1991-09, Vol.119 (3), p.424-428 |
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| container_title | The Journal of pediatrics |
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| creator | Goldsmith, Leonard S. Greenspan, Jay S. Rubenstein, S. David Wolfson, Maria R. Shaffer, Thomas H. |
| description | To determine whether changes in lung volume may be responsible for the clinical improvement in preterm infants given exogenous surfactant, we measured functional residual capacity (FRC), lung mechanics, and partial pressure of oxygen in seven ventilated neonates (birth weight 1080±361 gm (mean ± SD); gestational age 28.3±2.6 weeks) less than 9 hours of age who had findings typical of hyaline membrane disease. All patients received 100 mg/kg calf lung surfactant extract. FRC was measured by a closed-circuit helium-dilution technique, and lung mechanics were determined by least mean squares analysis, FRC increased in all patients (range 56% to 330%;
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| doi_str_mv | 10.1016/S0022-3476(05)82057-8 |
| format | Article |
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p<0.03). Dynamic lung compliance and total airway conductance did not change. Mean ± SEM specific lung compliance (dynamic lung compliance/FRC) decreased 55.93%±4.27% (
p<0.02) and mean specific conductance (total airway conductance/FRC) decreased 45.91%±9.74% (
p<0.009). Mean alveolar/arterial partial pressure of oxygen ratio decreased 51.0%±8.67% (
p<0.01). These data indicate that the immediate improvement in oxygenation after surfactant administration is related to increased lung volumes. The decrease in specific lung compliance and specific airway conductance is suggestive of increased distention rather than recruitment of functional alveoll.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/S0022-3476(05)82057-8</identifier><identifier>PMID: 1880658</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Functional Residual Capacity ; Humans ; Hyaline Membrane Disease - physiopathology ; Hyaline Membrane Disease - therapy ; Infant, Newborn ; Infant, Premature, Diseases - physiopathology ; Infant, Premature, Diseases - therapy ; Lung Compliance ; Pulmonary Gas Exchange - physiology ; Pulmonary Surfactants - therapeutic use</subject><ispartof>The Journal of pediatrics, 1991-09, Vol.119 (3), p.424-428</ispartof><rights>1991 The C. V. Mosby Company</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c275t-8848dbd287fd5f9a7842d5b514c12e98c4113015eab70f6dc839d77f5edab0eb3</citedby><cites>FETCH-LOGICAL-c275t-8848dbd287fd5f9a7842d5b514c12e98c4113015eab70f6dc839d77f5edab0eb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-3476(05)82057-8$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1880658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goldsmith, Leonard S.</creatorcontrib><creatorcontrib>Greenspan, Jay S.</creatorcontrib><creatorcontrib>Rubenstein, S. David</creatorcontrib><creatorcontrib>Wolfson, Maria R.</creatorcontrib><creatorcontrib>Shaffer, Thomas H.</creatorcontrib><title>Immediate improvement in lung volume after exogenous surfactant: Alveolar recruitment versus increased distention</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To determine whether changes in lung volume may be responsible for the clinical improvement in preterm infants given exogenous surfactant, we measured functional residual capacity (FRC), lung mechanics, and partial pressure of oxygen in seven ventilated neonates (birth weight 1080±361 gm (mean ± SD); gestational age 28.3±2.6 weeks) less than 9 hours of age who had findings typical of hyaline membrane disease. All patients received 100 mg/kg calf lung surfactant extract. FRC was measured by a closed-circuit helium-dilution technique, and lung mechanics were determined by least mean squares analysis, FRC increased in all patients (range 56% to 330%;
p<0.03). Dynamic lung compliance and total airway conductance did not change. Mean ± SEM specific lung compliance (dynamic lung compliance/FRC) decreased 55.93%±4.27% (
p<0.02) and mean specific conductance (total airway conductance/FRC) decreased 45.91%±9.74% (
p<0.009). Mean alveolar/arterial partial pressure of oxygen ratio decreased 51.0%±8.67% (
p<0.01). These data indicate that the immediate improvement in oxygenation after surfactant administration is related to increased lung volumes. The decrease in specific lung compliance and specific airway conductance is suggestive of increased distention rather than recruitment of functional alveoll.</description><subject>Functional Residual Capacity</subject><subject>Humans</subject><subject>Hyaline Membrane Disease - physiopathology</subject><subject>Hyaline Membrane Disease - therapy</subject><subject>Infant, Newborn</subject><subject>Infant, Premature, Diseases - physiopathology</subject><subject>Infant, Premature, Diseases - therapy</subject><subject>Lung Compliance</subject><subject>Pulmonary Gas Exchange - physiology</subject><subject>Pulmonary Surfactants - therapeutic use</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1O3TAUhK2qiF5oHwHJK1QWocdOHDtsKoT4k5BYQNeWY58gV4kDthPRt8fci9plV2cxM2c0HyFHDE4ZsPbHAwDnVd3I9juIE8VByEp9IhsGnaxaVdefyeav5Qs5SOk3AHQNwD7ZZ0pBK9SGvNxOEzpvMlI_Pcd5xQlDpj7QcQlPdJ3HZUJqhoyR4uv8hGFeEk1LHIzNJuQzej6uOI8m0og2Lj5v8yvGVHw-2IgmoaPOp1wEP4evZG8wY8JvH_eQ_Lq6fLy4qe7ur28vzu8qy6XIlVKNcr3jSg5ODJ2RquFO9II1lnHslG0Yq4EJNL2EoXVW1Z2TchDoTA_Y14fkePe3rHpZMGU9-WRxHE3AskFLDq3suCxGsTPaOKcUcdDP0U8m_tEM9DtqvUWt3zlqEHqLWquSO_ooWPrC8F9qx7boP3c6lpWrx6iT9RhswV1QZe1m_5-GNyzikWg</recordid><startdate>199109</startdate><enddate>199109</enddate><creator>Goldsmith, Leonard S.</creator><creator>Greenspan, Jay S.</creator><creator>Rubenstein, S. David</creator><creator>Wolfson, Maria R.</creator><creator>Shaffer, Thomas H.</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199109</creationdate><title>Immediate improvement in lung volume after exogenous surfactant: Alveolar recruitment versus increased distention</title><author>Goldsmith, Leonard S. ; Greenspan, Jay S. ; Rubenstein, S. David ; Wolfson, Maria R. ; Shaffer, Thomas H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c275t-8848dbd287fd5f9a7842d5b514c12e98c4113015eab70f6dc839d77f5edab0eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1991</creationdate><topic>Functional Residual Capacity</topic><topic>Humans</topic><topic>Hyaline Membrane Disease - physiopathology</topic><topic>Hyaline Membrane Disease - therapy</topic><topic>Infant, Newborn</topic><topic>Infant, Premature, Diseases - physiopathology</topic><topic>Infant, Premature, Diseases - therapy</topic><topic>Lung Compliance</topic><topic>Pulmonary Gas Exchange - physiology</topic><topic>Pulmonary Surfactants - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goldsmith, Leonard S.</creatorcontrib><creatorcontrib>Greenspan, Jay S.</creatorcontrib><creatorcontrib>Rubenstein, S. David</creatorcontrib><creatorcontrib>Wolfson, Maria R.</creatorcontrib><creatorcontrib>Shaffer, Thomas H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goldsmith, Leonard S.</au><au>Greenspan, Jay S.</au><au>Rubenstein, S. David</au><au>Wolfson, Maria R.</au><au>Shaffer, Thomas H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immediate improvement in lung volume after exogenous surfactant: Alveolar recruitment versus increased distention</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>1991-09</date><risdate>1991</risdate><volume>119</volume><issue>3</issue><spage>424</spage><epage>428</epage><pages>424-428</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To determine whether changes in lung volume may be responsible for the clinical improvement in preterm infants given exogenous surfactant, we measured functional residual capacity (FRC), lung mechanics, and partial pressure of oxygen in seven ventilated neonates (birth weight 1080±361 gm (mean ± SD); gestational age 28.3±2.6 weeks) less than 9 hours of age who had findings typical of hyaline membrane disease. All patients received 100 mg/kg calf lung surfactant extract. FRC was measured by a closed-circuit helium-dilution technique, and lung mechanics were determined by least mean squares analysis, FRC increased in all patients (range 56% to 330%;
p<0.03). Dynamic lung compliance and total airway conductance did not change. Mean ± SEM specific lung compliance (dynamic lung compliance/FRC) decreased 55.93%±4.27% (
p<0.02) and mean specific conductance (total airway conductance/FRC) decreased 45.91%±9.74% (
p<0.009). Mean alveolar/arterial partial pressure of oxygen ratio decreased 51.0%±8.67% (
p<0.01). These data indicate that the immediate improvement in oxygenation after surfactant administration is related to increased lung volumes. The decrease in specific lung compliance and specific airway conductance is suggestive of increased distention rather than recruitment of functional alveoll.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>1880658</pmid><doi>10.1016/S0022-3476(05)82057-8</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-3476 |
| ispartof | The Journal of pediatrics, 1991-09, Vol.119 (3), p.424-428 |
| issn | 0022-3476 1097-6833 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Functional Residual Capacity Humans Hyaline Membrane Disease - physiopathology Hyaline Membrane Disease - therapy Infant, Newborn Infant, Premature, Diseases - physiopathology Infant, Premature, Diseases - therapy Lung Compliance Pulmonary Gas Exchange - physiology Pulmonary Surfactants - therapeutic use |
| title | Immediate improvement in lung volume after exogenous surfactant: Alveolar recruitment versus increased distention |
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