Long growth, structural remodeling, surfactant levels, and lung function after reversible fetal lamb tracheal occlusion in congenital diaphragmatic hernia

The effects of reversible fetal tracheal occlusion (TO), and antenatal glucocorticoids on lung growth, structure, surfactant levels, and function were assessed in a lamb hypoplastic lung model of congenital diaphragmatic hernia (CDH). CDH, CDH+TO, CDH+TO+release of the tracheal occlusion one week before delivery (TR), and unoperated twin controls were compared. TO+/-TR partially normalized the hypoplastic lungs of CDH: they accelerated growth of both lungs and led to structural maturity. Only TO thinned the medial area of small pulmonary arteries closer to control values. Despite TO, TR, and glucocorticoids, lungs from lambs with CDH have dysfunctional type II cells with decreased surfactant levels. Nonetheless, CDH+TO lambs showed normal oxygenation, ventilation, and compliance over untreated CDH, with a clear survival advantage over an eight hour resuscitation. TR one week before delivery had no added benefit in terms of lung function. It appears that surfactant independent mechanisms such as pulmonary growth and structural changes are of foremost importance in relating to improved compliance, oxygenation, and ventilation of CDH+TO animals.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33383
Date January 2000
CreatorsBratu, Ioana.
ContributorsFlageole, H. (advisor), Laberge, J-M. (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageMaster of Science (Division of Surgical Research.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001771635, proquestno: MQ70693, Theses scanned by UMI/ProQuest.

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