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J Appl Physiol 83: 1054-1061, 1997;
8750-7587/97 $5.00
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Journal of Applied Physiology
Vol. 83, No. 4, pp. 1054-1061, October 1997
GAS EXCHANGE, MECHANICS, AND AIRWAYS

Tidal volume effects on surfactant treatment responses with the initiation of ventilation in preterm lambs

Kazuko Wada, Alan H. Jobe, and Machiko Ikegami

Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California 90502

Received 7 March 1997; accepted in final form 15 May 1997.

Wada, Kazuko, Alan H. Jobe, and Machiko Ikegami. Tidal volume effects on surfactant treatment responses with the initiation of ventilation in preterm lambs. J. Appl. Physiol. 83(4): 1054-1061, 1997.---We hypothesized that initiation of ventilation in preterm lambs with high volumes would cause lung injury and decrease the subsequent response to surfactant treatment. Preterm lambs were randomized to ventilation for 30 min after birth with 5 ml/kg (VT5), 10 ml/kg (VT10), or 20 ml/kg (VT20) tidal volumes and then ventilated with ~10 ml/kg tidal volumes to achieve arterial PCO2 values of ~50 Torr to 6 h of age. VT20 lambs had lower compliances, lower ventilatory efficiencies, higher recoveries of protein, and lower recoveries of surfactant in alveolar lavages and in surfactant that had decreased compliances when tested in preterm rabbits than VT5 or VT10 lambs. Other lambs randomized to treatment with surfactant at birth and ventilation with 6, 12, or 20 ml/kg tidal volumes for 30 min had no indicators of lung injury. An initial tidal volume of 20 ml/kg decreased the subsequent response to surfactant treatment, an effect that was prevented with surfactant treatment at birth.

respiratory distress syndrome; lung injury; compliance; dipalmitoylphosphatidylcholine; arterial carbon dioxide partial pressure

0161-7567/97 $5.00 Copyright © 1997 the American Physiological Society




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