Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_RS |
Texto Completo: | http://tede2.pucrs.br/tede2/handle/tede/1393 |
Resumo: | BACKGROUND: Due to meconium's obstructive effect on the airways and its inhibitory action over the surfactant system, treatment with bronchoalveolar lavage and surfactant replacement are currently under evaluation. OBJECTIVE: To evaluate, in an experimental model, the effect on the arterial blood gases and pulmonary mechanics of the treatment of meconium aspiration syndrome with exogenous surfactant, preceded or not of bronchoalveolar lavage with diluted surfactant in low volumes. DESIGN/METHODS: 21 newborn piglets were mechanically ventilated with predetermined settings. Meconium aspiration syndrome was induced by instillation of 5 ml/kg of meconium 20% diluted in isotonic saline, and afterwards the piglets were randomly allocated to: group I (n=7) - control; group II (n=7) - surfactant (Curosurf?) 200mg/kg; group III (n=7) - bronchoalveolar lavage with diluted surfactant 5mg/ml (15 ml/kg in 2ml aliquots), followed by a supplementary dose of surfactant 125mg/kg. Arterial blood gases, compliance, resistance, and tidal volume were measured five times at specific intervals during the six hours of the study. RESULTS: After instillation of meconium, before treatment, the PaO2 fell to a mean of 50mmHg and the PaCO2 increased to 76mmHg (no statistically difference among groups). Mean PaO2 (mmHg) in groups I, II and III were 72, 106 and 172 (p=0,01); 70, 95 and 198 (p<0.01); 79, 110 and 217 (p=0.01) at 30 minutes, 3 and 6 hours after treatment, respectively. Mean PaCO2 (mmHg) in Groups I, II and III were 81, 65 and 35 (p=0.01); 82, 59 and 37 (p=0.01); 82, 75 and 32 (p<0.01) at 30', 3 and 6 hours after treatment, respectively. Mean Compliance (ml/cmH2O) in Groups I, II, III were 0.76, 1.01 and 1.57 (p<0.05); 1.02, 0.69, e 1.79(p<0.05) at 30 minutes and 6 hours after treatment, respectively. Mean resistance (cmH2O/L/S) in Groups I, II, III were 422.57, 385.29 and 268.86 (p<0.05); 408.83, 564.86 e 248.43(p<0.05) at 30 minutes and 6 hours after treatment, respectively. CONCLUSIONS: Bronchoalveolar lavage with diluted surfactant, with low volumes and small aliquots, followed by a supplementary dose of surfactant, significantly improved arterial blood gases and pulmonary function measurements when compared to the administration of a single dose of surfactant in an experimental model of meconium aspiration syndrome. |
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Fiori, Renato MachadoCPF:00096121068http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4783043Y3CPF:50047205091http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4709310P2Henn, Roseli2015-04-14T13:32:58Z2012-06-112011-12-20HENN, Roseli. Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio. 2011. 101 f. Tese (Doutorado em Pediatria e Sa?de da Crian?a) - Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2011.http://tede2.pucrs.br/tede2/handle/tede/1393BACKGROUND: Due to meconium's obstructive effect on the airways and its inhibitory action over the surfactant system, treatment with bronchoalveolar lavage and surfactant replacement are currently under evaluation. OBJECTIVE: To evaluate, in an experimental model, the effect on the arterial blood gases and pulmonary mechanics of the treatment of meconium aspiration syndrome with exogenous surfactant, preceded or not of bronchoalveolar lavage with diluted surfactant in low volumes. DESIGN/METHODS: 21 newborn piglets were mechanically ventilated with predetermined settings. Meconium aspiration syndrome was induced by instillation of 5 ml/kg of meconium 20% diluted in isotonic saline, and afterwards the piglets were randomly allocated to: group I (n=7) - control; group II (n=7) - surfactant (Curosurf?) 200mg/kg; group III (n=7) - bronchoalveolar lavage with diluted surfactant 5mg/ml (15 ml/kg in 2ml aliquots), followed by a supplementary dose of surfactant 125mg/kg. Arterial blood gases, compliance, resistance, and tidal volume were measured five times at specific intervals during the six hours of the study. RESULTS: After instillation of meconium, before treatment, the PaO2 fell to a mean of 50mmHg and the PaCO2 increased to 76mmHg (no statistically difference among groups). Mean PaO2 (mmHg) in groups I, II and III were 72, 106 and 172 (p=0,01); 70, 95 and 198 (p<0.01); 79, 110 and 217 (p=0.01) at 30 minutes, 3 and 6 hours after treatment, respectively. Mean PaCO2 (mmHg) in Groups I, II and III were 81, 65 and 35 (p=0.01); 82, 59 and 37 (p=0.01); 82, 75 and 32 (p<0.01) at 30', 3 and 6 hours after treatment, respectively. Mean Compliance (ml/cmH2O) in Groups I, II, III were 0.76, 1.01 and 1.57 (p<0.05); 1.02, 0.69, e 1.79(p<0.05) at 30 minutes and 6 hours after treatment, respectively. Mean resistance (cmH2O/L/S) in Groups I, II, III were 422.57, 385.29 and 268.86 (p<0.05); 408.83, 564.86 e 248.43(p<0.05) at 30 minutes and 6 hours after treatment, respectively. CONCLUSIONS: Bronchoalveolar lavage with diluted surfactant, with low volumes and small aliquots, followed by a supplementary dose of surfactant, significantly improved arterial blood gases and pulmonary function measurements when compared to the administration of a single dose of surfactant in an experimental model of meconium aspiration syndrome.INTRODU??O: devido ao efeito obstrutivo do mec?nio nas vias a?reas e a a??o inibit?ria sobre o sistema surfactante, o lavado broncoalveolar e a reposi??o de surfactante est?o sendo avaliados nos ?ltimos tempos para o tratamento da s?ndrome da aspira??o de mec?nio. OBJETIVO: Avaliar, em modelo experimental, o efeito sobre os gases sangu?neos arteriais e a mec?nica pulmonar do tratamento da s?ndrome de aspira??o de mec?nio grave com surfactante ex?geno, precedido ou n?o de lavado broncoalveolar com surfactante dilu?do em pequenos volumes. M?TODOS: 21 porcos rec?m-nascidos eram ventilados mecanicamente com par?metros respirat?rios predeterminados. Para induzir a s?ndrome de aspira??o de mec?nio foi instilado 5ml/kg de mec?nio dilu?do a 20% em solu??o salina isot?nica. Ap?s, os porcos foram randomizados em 3 grupos: grupo I (n=7) - controle; grupo II (n=7) - surfactante (Curosurf?) 200mg/kg; grupo III (n=7) - lavado broncoalveolar com surfactante dilu?do 5mg/ml (15ml/kg em al?quotas de 2ml) seguido de uma dose suplementar de surfactante 125mg/kg. Gases arteriais sangu?neos, complac?ncia, resist?ncia e volume corrente foram avaliados durante as 6 horas do estudo em 5 momentos espec?ficos. RESULTADOS: ap?s a instila??o de mec?nio, antes do tratamento, a PaO2 caiu para uma m?dia em torno de 50mmHg e a PaCO2 aumentou para uma m?dia em torno de 76mmHg, n?o havendo diferen?a significativa entre os grupos. Ap?s o tratamento a m?dia da PaO2(mmHg) nos grupos I, II e III aos 30 minutos, 3 e 6 horas foi de 72, 106 e 172 (p=0,01) - 70, 95 e 198 (p<0,01) e 79, 110 e 217 (p=0,01), respectivamente. A m?dia da PaCO2 (mmHg) nos grupos I, II e III foi 81, 65 e 35 (p=0,01) - 82, 59 e 37 (p=0,01) e 83, 75 e 33 (p<0,01), respectivamente. Ap?s o tratamento a m?dia da complac?ncia (ml/cmH2O) aos 30 minutos e 6 horas nos grupos I, II, III foi de 0,76, 1,01 e 1,57(p<0,05) e de 1,02, 0,69 e 1,79 (p<0,05), respectivamente. A m?dia da resist?ncia (cmH2O/L/S) nos grupos I, II e III foi de 422,57, 385,29 e 268,86(p<0,05) e de 408,83, 564,86 e 248,43 (p<0,05) aos 30 minutos e 6 horas, respectivamente. CONCLUS?O: o lavado broncoalveolar com surfactante dilu?do, com baixos volumes e pequenas al?quotas, seguido por uma dose suplementar de surfactante, melhorou significativamente os gases sangu?neos arteriais e a mec?nica pulmonar quando comparado com uma dose de surfactante sem lavado broncoalveolar e com um grupo controle, em um modelo experimental de s?ndrome de aspira??o de mec?nio.Made available in DSpace on 2015-04-14T13:32:58Z (GMT). No. of bitstreams: 1 438704.pdf: 1089872 bytes, checksum: 26e9b82adb7d51a185543e38c2cdc8d2 (MD5) Previous issue date: 2011-12-20application/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/8623/438704.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?aPUCRSBRFaculdade de MedicinaMEDICINAPEDIATRIAASPIRA??O DE MEC?NIOSURFACTANTES PULMONARESLAVAGEM BRONCOALVEOLARNEONATOLOGIAREC?M-NASCIDO - DOEN?ASANIMAIS - EXPERI?NCIASCNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::PEDIATRIASurfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nioinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis3098206005268432148500600 8624664729441623247info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAIL438704.pdf.jpg438704.pdf.jpgimage/jpeg3131http://tede2.pucrs.br/tede2/bitstream/tede/1393/3/438704.pdf.jpg4bf8ab2497c27a0783d9427fa28517c1MD53TEXT438704.pdf.txt438704.pdf.txttext/plain134912http://tede2.pucrs.br/tede2/bitstream/tede/1393/2/438704.pdf.txt5c7444e867befc75a6c736c8d878f0dbMD52ORIGINAL438704.pdfapplication/pdf1089872http://tede2.pucrs.br/tede2/bitstream/tede/1393/1/438704.pdf26e9b82adb7d51a185543e38c2cdc8d2MD51tede/13932015-04-30 08:15:45.129oai:tede2.pucrs.br:tede/1393Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2015-04-30T11:15:45Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio |
title |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio |
spellingShingle |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio Henn, Roseli MEDICINA PEDIATRIA ASPIRA??O DE MEC?NIO SURFACTANTES PULMONARES LAVAGEM BRONCOALVEOLAR NEONATOLOGIA REC?M-NASCIDO - DOEN?AS ANIMAIS - EXPERI?NCIAS CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::PEDIATRIA |
title_short |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio |
title_full |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio |
title_fullStr |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio |
title_full_unstemmed |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio |
title_sort |
Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio |
author |
Henn, Roseli |
author_facet |
Henn, Roseli |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Fiori, Renato Machado |
dc.contributor.advisor1ID.fl_str_mv |
CPF:00096121068 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4783043Y3 |
dc.contributor.authorID.fl_str_mv |
CPF:50047205091 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4709310P2 |
dc.contributor.author.fl_str_mv |
Henn, Roseli |
contributor_str_mv |
Fiori, Renato Machado |
dc.subject.por.fl_str_mv |
MEDICINA PEDIATRIA ASPIRA??O DE MEC?NIO SURFACTANTES PULMONARES LAVAGEM BRONCOALVEOLAR NEONATOLOGIA REC?M-NASCIDO - DOEN?AS ANIMAIS - EXPERI?NCIAS |
topic |
MEDICINA PEDIATRIA ASPIRA??O DE MEC?NIO SURFACTANTES PULMONARES LAVAGEM BRONCOALVEOLAR NEONATOLOGIA REC?M-NASCIDO - DOEN?AS ANIMAIS - EXPERI?NCIAS CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::PEDIATRIA |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::PEDIATRIA |
description |
BACKGROUND: Due to meconium's obstructive effect on the airways and its inhibitory action over the surfactant system, treatment with bronchoalveolar lavage and surfactant replacement are currently under evaluation. OBJECTIVE: To evaluate, in an experimental model, the effect on the arterial blood gases and pulmonary mechanics of the treatment of meconium aspiration syndrome with exogenous surfactant, preceded or not of bronchoalveolar lavage with diluted surfactant in low volumes. DESIGN/METHODS: 21 newborn piglets were mechanically ventilated with predetermined settings. Meconium aspiration syndrome was induced by instillation of 5 ml/kg of meconium 20% diluted in isotonic saline, and afterwards the piglets were randomly allocated to: group I (n=7) - control; group II (n=7) - surfactant (Curosurf?) 200mg/kg; group III (n=7) - bronchoalveolar lavage with diluted surfactant 5mg/ml (15 ml/kg in 2ml aliquots), followed by a supplementary dose of surfactant 125mg/kg. Arterial blood gases, compliance, resistance, and tidal volume were measured five times at specific intervals during the six hours of the study. RESULTS: After instillation of meconium, before treatment, the PaO2 fell to a mean of 50mmHg and the PaCO2 increased to 76mmHg (no statistically difference among groups). Mean PaO2 (mmHg) in groups I, II and III were 72, 106 and 172 (p=0,01); 70, 95 and 198 (p<0.01); 79, 110 and 217 (p=0.01) at 30 minutes, 3 and 6 hours after treatment, respectively. Mean PaCO2 (mmHg) in Groups I, II and III were 81, 65 and 35 (p=0.01); 82, 59 and 37 (p=0.01); 82, 75 and 32 (p<0.01) at 30', 3 and 6 hours after treatment, respectively. Mean Compliance (ml/cmH2O) in Groups I, II, III were 0.76, 1.01 and 1.57 (p<0.05); 1.02, 0.69, e 1.79(p<0.05) at 30 minutes and 6 hours after treatment, respectively. Mean resistance (cmH2O/L/S) in Groups I, II, III were 422.57, 385.29 and 268.86 (p<0.05); 408.83, 564.86 e 248.43(p<0.05) at 30 minutes and 6 hours after treatment, respectively. CONCLUSIONS: Bronchoalveolar lavage with diluted surfactant, with low volumes and small aliquots, followed by a supplementary dose of surfactant, significantly improved arterial blood gases and pulmonary function measurements when compared to the administration of a single dose of surfactant in an experimental model of meconium aspiration syndrome. |
publishDate |
2011 |
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2011-12-20 |
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2012-06-11 |
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2015-04-14T13:32:58Z |
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info:eu-repo/semantics/publishedVersion |
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HENN, Roseli. Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio. 2011. 101 f. Tese (Doutorado em Pediatria e Sa?de da Crian?a) - Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2011. |
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http://tede2.pucrs.br/tede2/handle/tede/1393 |
identifier_str_mv |
HENN, Roseli. Surfactante com e sem lavado broncoalveolar em modelo experimental de s?ndrome de aspira??o de mec?nio. 2011. 101 f. Tese (Doutorado em Pediatria e Sa?de da Crian?a) - Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2011. |
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http://tede2.pucrs.br/tede2/handle/tede/1393 |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a |
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PUCRS |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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