Details

Autor(en) / Beteiligte

• Khalife, T
• Sage, E
• Dorfmuller, P
• Eddahibi, S
• Fadel, E

Titel

Lung Injuries Induced by Gastric Acid Aspiration Are Attenuated by Exogenous Surfactant during Ex Vivo Reconditioning in Pigs

Ist Teil von

• The Journal of heart and lung transplantation, 2013-04, Vol.32 (4), p.S47-S47

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2013

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Purpose Gastric acid aspiration is a common reason for rejecting lungs for transplantation as it is associated with increased risks of graft dysfunction. We investigated Ex vivo lung perfusion (EVLP) reconditioning on lung injuries due to gastric acid aspiration and effects of surfactant administration. Methods and Materials 30 piglets were allocated to 5 groups. Aspiration lung injury (LI) was induced by infusing 1 ml/kg of autologous gastric juice into the left lower lobe (LLL). 24 hours later, the lungs were studied (LI group) or reconditioned using EVLP for 4 hours without additional treatment (LI-EVLP group) or after surfactant lavage (curosurf 100 mg/kg) in the LLL (Surf-EVLP group). Sham animals were studied 24 h after saline infusion and Sham-EVLP animals 24 h after saline infusion followed by 4 h of EVLP. Gross anatomy, hemodynamics, and aerodynamics were evaluated; neutrophil and bacterial counts in bronchoalveolar lavage (BAL) fluid and blood were determined. LLLs were evaluated by tissue wet/dry ratio; histology (semi-quantitative severity score); apoptotic cell using TUNEL; and IL-1, IL-6, IL-8, IL-10, and TNFa protein levels. Results There were no significant differences between the Sham and Sham-EVLP groups. Compared to Sham, LI animals had irreversible atelectasis, a higher lung infection rate (P<0.0001), higher BAL neutrophil percentage (P<0.0001), lower PaO2 (P=0.0006), higher IL1 (P=0.022) and IL8 (P=0.006) levels and apoptotic cell percentage (P=0.007), and worse histology severity score (P<0.0001). In the LI-EVLP group, these altered values were not improved, and the LLLs showed bleeding by gross anatomy and an increased apoptotic cell percentage (P=0.004) compared to the LI group. In the Surf-EVLP group, PaO2 and apoptotic cell percentage returned to sham values while histology severity score was only partially improved (p=0.009). Conclusions Although 4 hours EVLP worsened LI due to gastric acid aspiration, when preceded by local infusion of surfactant it allowed complete PaO2 and partial histology recovery.