Abstract
Objective: Intra-amniotic administration of surfactant (IAS) in the preterm baboon 24 h before delivery reduces the clinical and pathological aspects of hyaline membrane disease (HMD) when compared to saline controls. The purpose of this study is to describe clinical, radiographical, and pathological endpoints of HMD in the preterm baboon treated with a single intratracheal dose of surfactant (ITS) for comparison with those of IAS and intra-amniotic saline-treated control groups. Methods: Five preterm baboons received control intra-amniotic saline injections before delivery and ITS (4 ml/kg Survanta, Ross Laboratories, Cincinnati, Ohio) following delivery. An additional saline-treated baboon was delivered but not given surfactant. Fetuses were delivered at 137-139 days' gestation, maintained for 24 h using standard neonatal intensive care techniques and assessed for study endpoints. These data were compared to those from our previous report to assess differences between intratracheal and intra-amniotic administration of surfactant and controls. Results: Compared to saline controls, ITS- and IAS-treated animals had significantly better clinical courses, as documented by PaO2/PAO2 (p < 0.05), FiO2 (p < 0.01), and PaCO2 (p < 0.05). Saline controls had significantly more evidence of HMD than intra-amniotic and intratracheal surfactant-treated animals in blindly scored radiographs (p < 0.03). Using a panel-of-standards method blindly to score pathological findings in the fixed left lung, those treated with intra-amniotic and intratracheal surfactant had significantly more inflation (p < 0.05) than saline-treated animals. ITS- and IAS-treated animals had no differences in study endpoints. Animals receiving intratracheal surfactant tended to have residual inflation in the central and medial aspects of each lobe, in contrast to intra-amniotic surfactant-treated animals which had a more even distribution of inflation. Conclusion: Intratracheal surfactant treatment improves the clinical, radiographical and pathological aspects of respiratory distress in the preterm baboon, but does not prevent hyaline membrane disease in this established model. Variations in distribution of inflation between intratracheal and intra-amniotic surfactant-treated animals suggest differences in pulmonary distribution of surfactant that depend on the route of administration.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 122-130 |
| Number of pages | 9 |
| Journal | Prenatal and Neonatal Medicine |
| Volume | 1 |
| Issue number | 2 |
| State | Published - 1996 |
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Keywords
- Baboon
- Hyaline membrane disease
- In utero therapy
- Pregnancy
- Preterm delivery
- Surfactant prophylaxis
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Hyaline membrane surfactant prophylaxis in the preterm baboon : A comparison of postpartum versus in utero therapy. / Galan, H. L.; Cipriani, C.; Coalson, J. J.; Bean-Lijewski, J. D.; Collier, G.; Kuehl, T. J.
In: Prenatal and Neonatal Medicine, Vol. 1, No. 2, 1996, p. 122-130.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hyaline membrane surfactant prophylaxis in the preterm baboon
T2 - A comparison of postpartum versus in utero therapy
AU - Galan, H. L.
AU - Cipriani, C.
AU - Coalson, J. J.
AU - Bean-Lijewski, J. D.
AU - Collier, G.
AU - Kuehl, T. J.
PY - 1996
Y1 - 1996
N2 - Objective: Intra-amniotic administration of surfactant (IAS) in the preterm baboon 24 h before delivery reduces the clinical and pathological aspects of hyaline membrane disease (HMD) when compared to saline controls. The purpose of this study is to describe clinical, radiographical, and pathological endpoints of HMD in the preterm baboon treated with a single intratracheal dose of surfactant (ITS) for comparison with those of IAS and intra-amniotic saline-treated control groups. Methods: Five preterm baboons received control intra-amniotic saline injections before delivery and ITS (4 ml/kg Survanta, Ross Laboratories, Cincinnati, Ohio) following delivery. An additional saline-treated baboon was delivered but not given surfactant. Fetuses were delivered at 137-139 days' gestation, maintained for 24 h using standard neonatal intensive care techniques and assessed for study endpoints. These data were compared to those from our previous report to assess differences between intratracheal and intra-amniotic administration of surfactant and controls. Results: Compared to saline controls, ITS- and IAS-treated animals had significantly better clinical courses, as documented by PaO2/PAO2 (p < 0.05), FiO2 (p < 0.01), and PaCO2 (p < 0.05). Saline controls had significantly more evidence of HMD than intra-amniotic and intratracheal surfactant-treated animals in blindly scored radiographs (p < 0.03). Using a panel-of-standards method blindly to score pathological findings in the fixed left lung, those treated with intra-amniotic and intratracheal surfactant had significantly more inflation (p < 0.05) than saline-treated animals. ITS- and IAS-treated animals had no differences in study endpoints. Animals receiving intratracheal surfactant tended to have residual inflation in the central and medial aspects of each lobe, in contrast to intra-amniotic surfactant-treated animals which had a more even distribution of inflation. Conclusion: Intratracheal surfactant treatment improves the clinical, radiographical and pathological aspects of respiratory distress in the preterm baboon, but does not prevent hyaline membrane disease in this established model. Variations in distribution of inflation between intratracheal and intra-amniotic surfactant-treated animals suggest differences in pulmonary distribution of surfactant that depend on the route of administration.
AB - Objective: Intra-amniotic administration of surfactant (IAS) in the preterm baboon 24 h before delivery reduces the clinical and pathological aspects of hyaline membrane disease (HMD) when compared to saline controls. The purpose of this study is to describe clinical, radiographical, and pathological endpoints of HMD in the preterm baboon treated with a single intratracheal dose of surfactant (ITS) for comparison with those of IAS and intra-amniotic saline-treated control groups. Methods: Five preterm baboons received control intra-amniotic saline injections before delivery and ITS (4 ml/kg Survanta, Ross Laboratories, Cincinnati, Ohio) following delivery. An additional saline-treated baboon was delivered but not given surfactant. Fetuses were delivered at 137-139 days' gestation, maintained for 24 h using standard neonatal intensive care techniques and assessed for study endpoints. These data were compared to those from our previous report to assess differences between intratracheal and intra-amniotic administration of surfactant and controls. Results: Compared to saline controls, ITS- and IAS-treated animals had significantly better clinical courses, as documented by PaO2/PAO2 (p < 0.05), FiO2 (p < 0.01), and PaCO2 (p < 0.05). Saline controls had significantly more evidence of HMD than intra-amniotic and intratracheal surfactant-treated animals in blindly scored radiographs (p < 0.03). Using a panel-of-standards method blindly to score pathological findings in the fixed left lung, those treated with intra-amniotic and intratracheal surfactant had significantly more inflation (p < 0.05) than saline-treated animals. ITS- and IAS-treated animals had no differences in study endpoints. Animals receiving intratracheal surfactant tended to have residual inflation in the central and medial aspects of each lobe, in contrast to intra-amniotic surfactant-treated animals which had a more even distribution of inflation. Conclusion: Intratracheal surfactant treatment improves the clinical, radiographical and pathological aspects of respiratory distress in the preterm baboon, but does not prevent hyaline membrane disease in this established model. Variations in distribution of inflation between intratracheal and intra-amniotic surfactant-treated animals suggest differences in pulmonary distribution of surfactant that depend on the route of administration.
KW - Baboon
KW - Hyaline membrane disease
KW - In utero therapy
KW - Pregnancy
KW - Preterm delivery
KW - Surfactant prophylaxis
UR - http://www.scopus.com/inward/record.url?scp=0011328304&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0011328304&partnerID=8YFLogxK
M3 - Article
VL - 1
SP - 122
EP - 130
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
SN - 1476-7058
IS - 2
ER -