Background Lung lavage in meconium aspiration syndrome (MAS) could be a good alternative by removing meconium and achieving better distribution in a non-homogeneous injured lung.
Objective To study the effects of lung lavage with saline solution (SS), diluted surfactant (dSF) and perfluorocarbon (PFC) in experimental MAS.
Methods Lambs (<6 d) were mechanically ventilated (CMV) for 180 min. Animals received 20% meconium (3–5 mL/Kg) and were randomly assigned to groups (n = 6). eMAS: CMV; SS-lavage: 30 mL/Kg of saline, dSF-lavage: 16 mL/Kg of Surfaxin® (10 mg/mL); PFC-lavage: 30 mL/Kg of FC-75. Haemodynamic parameters, blood gases, and pulmonary mechanics were registered. ANOVA, p <0.05.
Results After meconium severe hypoxia, hypercapnia and acidosis were developed. After lung lavage with dSF, PaO2 and pH were higher and PaCO2 lower (maximum PaO2 163 vs 66/130 and minimum PaCO2 30 vs 80/39 mmHg (p<0.05)) than in eMAS/PFC-lavaged groups. In all lavaged groups, arterial pressure decreased (p<0.05) during delivery, maintaining values for all experiment, with a slow trend to recover basal values. Heart rate was maintained in all groups. Dynamic compliance (Cdyn) decreased and airway resistance (Raw) increased after meconium. No changes in Cdyn were registered. Raw decreased in dSF-lavaged group (p<0.05 vs PFC-lavaged group). Gas exchange, cardiovascular profile and pulmonary mechanics were similar in all lavaged groups.
Conclusions In lambs with eMAS, lung lavage with SS, dSF and PFC had no different effect on gas exchange, cardiovascular profile or pulmonary mechanics. Lung lavage with dSF improved gas exchange in comparison to eMAS group.