Abstract
Objectives To test the hypothesis that surfactant, when given prophylactically during one lung ventilation (OLV), improves physiological stability and reduces inflammation. Methods Prospective controlled animal study. After 30min of mechanical ventilation, surfactant was administered to the left lung of the treatment group. Right lung mechanical ventilation continued for 3hr, after which the left lung was unblocked. Bilateral mechanical ventilation was continued for 30min thereafter. Physiological parameters and biomarkers of inflammation in plasma, lung tissue homogenates, and bronchoalveolar lavage (BAL) were measured. Measurements and Main Results Oxygenation improved in the surfactant group, reaching statistical significance at 3hr of OLV and again after 30min of bilateral mechanical ventilation following the OLV. Plasma levels of interleukin (IL)-1 β, IL-6, and tumor necrosis factor (TNF)-α showed a trend for reduction. The lung homogenates from the ventilated lungs had significantly lower levels of IL-1 β (P<0.01) and IL-6 (P<0.01). The BAL specimen showed an overall reduction in the cytokine levels; IL-1 β was significantly lower in the ventilated lungs (P<0.01). Conclusions Surfactant administration improves oxygenation and decreases inflammation, as evidenced by a decrease in several inflammatory cytokines both in the plasma and lungs of a piglet model of OLV. Copyright © 2011 Wiley Periodicals, Inc.