Addition of trehalose to dipalmitoyl phosphatidylcholine, hexadecanaol and tyloxapol improves oxygenation in surfactant-deficient rabbits

Smith J. ; Hoal E.G. ; Coetzee A.R. ; Van Helden P.D. ; Maritz J.S. ; Pieper C.H. ; James R. ; Van Rensburg J.J. (2006)


We seek to develop a safe and cheap synthetic lung surfactant as a substitute for expensive, mammalian-derived products. The postinstillation physiological effects of three synthetic surfactant preparations in three treatment groups of adult New Zealand white rabbits, on gas exchange, percentage calculated shunt and histopathological changes, were compared with those of a saline-treated control group. Improvement in oxygenation and a reduction in percentage shunt occurred to a similar extent after instillation of a mixture of dipalmitoylphosphatidylcholine, tyloxapol, cetyl alcohol and a nonreducing disaccharide (trehalose), and the commercial product Exosurf Neonatal®, surpassing that of 'Exosurf, a synthetic formulation of the same composition as the other prepared on-site, or saline treatment. Intratracheal instillation of surfactants did not restore the lung to its pre-lavage condition. Lung light microscopy findings differed in regard to the presence of hyaline membranes. The mixture of dipalmitoylphosphatidylcholine with trehalose performed similarly to Exosurf Neonatal®, with neither the superior.

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