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Ernesto Valdes MD, Guest Editor
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Lung Lavage in Meconium Aspiration
Therapeutic Lung Lavage in the Piglet Model of Meconium Aspiration Syndrome. Dargaville, Peter A., et al. American Journal of Respiratory and Critical Care Medicine (August 2003);168;No. 4;456-463.
Objective: To investigate the type of fluid and aliquot volume most appropriate for lung lavage in this condition.
Meconium injury was induced in 2-week-old piglets, followed by a 30 ml/kg lavage in two aliquots 40 minutes later. Lavage with either dilute bovine surfactant (2.5 mg/ml) or a perfluorocarbon emulsion (20% wt/vol) improved oxygenation compared with a nonlavaged control group. But diluted surfactant was better in sustaining oxygenation. It has been shown that diluted surfactant improves oxygenation better than either no lavage, or bolus surfactant therapy in MAS; and that saline is an inferior lavage fluid to surfactant or perfluorocarbon. There was histological and biochemical evidence of decreased lung injury in the diluted surfactant group. It was also associated with increased meconium removal. They suggest it should be evaluated in human infants.
Comment: I am certainly willing to try this study to keep lung
injury to a minimum. E.V.
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