Exogenous surfactant replacement immediately at birth as preventive therapy for lung prematurity in neonatal lambs.

Surfactant treatment is a manner to reduce alveolar superficial tension and increase pulmonary compliance in premature neonates. Thus, we aimed to analyze the effect of exogenous surfactant treatment in combination with manual ventilation for preterm lambs. We used 15 ewes and their lambs (n = 16), prematurely born at 135 days. At birth, lambs were submitted to orotracheal intubation attached to a handheld resuscitation device and randomly allocated to: Control Group (n = 5; only manual ventilation), Single Surfactant Group (n = 5; manual ventilation coupled by intratracheal administration of 100 mg/kg surfactant) and Double Surfactant Group (n = 6; surfactant volume was divided into two doses (50 mg/kg + 50 mg/kg) administrated at birth and 30 min thereafter). A complete physical exam, arterial gas analysis, blood glucose, urea and creatinine concentration and chest radiographic assessment were performed at fixed times. All lambs had decreased body temperature until 20 min after birth. However, control and double surfactant groups reached a thermic plateau after 30 min. Regardless of the time-point, control lambs had higher heart rate in comparison to treated neonates, including bradycardia in Single Surfactant Group. Single instillation led to lower oxygenation degree, compared to the Double Surfactant Group, suggesting that surfactant treatment was not able to adequately spread within the alveoli. Lambs treated with surfactant had severe impairment of aerobic activity, leading to anaerobic metabolism. All groups had hypercapnia, which can be explained by inadequate respiratory pattern and pulmonary opacity (89% of the lambs had severe or moderate lung content). In conclusion, exogenous surfactant therapy in association with manual ventilation is ineffective in reverting pulmonary immaturity of the preterm lamb, leading to less vitality, hypoxemia, delayed pulmonary clearance and high mortality rate.

Perfil de proteínas plasmáticas em cadelas gestantes e não gestantes / Plasmatic protein profile of pregnant and non-pregnant bitches

O estudo das interações orgânicas da gestação e as mudanças fisiológicas que estão ocorrendo nesta fase são de extrema importância para a avaliação clínica da fêmea gestante ou para estabelecer o diagnóstico de processos patológicos em andamento. O objetivo do presente estudo foi comparar o perfil das diversas proteínas sanguíneas (frações protéicas do soro - albumina, a1, a2, b, g globulinas e proteína total) durante o período gestacional e no diestro em cadelas. Foram utilizadas 40 fêmeas caninas da raça Dogue Alemão, em idade variando entre 2 a 7 anos, clinicamente saudáveis. Os animais foram separados em dois grupos, denominados Grupo não gestante (NG) e Grupo gestante (G), constituídos por 20 fêmeas em diestro e 20 fêmeas gestantes, respectivamente. Preconizou-se colheita de sangue semanalmente de cada animal durante 9 semanas. Nas fêmeas do grupo NG, as amostras foram colhidas a partir do início do diestro, até a detecção do início do anestro; no grupo G, as amostras foram colhidas do início do diestro até o momento da parição. A partir do soro sanguíneo, foram determinadas as concentrações de proteína total, albumina, a1, a2, b e g globulinas. Não houve diferença significativa quanto aos resultados de proteína sérica total entre a 1ª e 6ª semanas de gestação e diestro, havendo decréscimo gradual em ambos grupos. Já ao final da gestação (entre a 7ª e 9ª semanas), houve acréscimo significativo dos valores de proteína total, sugerindo ação anabólica. Os níveis de albumina sofreram queda da 1ª a 9ª semana, tanto no grupo gestante, como não-gestante, com diferença estatística entre os dois grupos na 7ª, 8ª e 9ª semanas. As concentrações de α1 globulina nas fêmeas gestantes sofreram acréscimo significativo a partir da 2ª semana, contudo, diferença estatística entre os grupos NG e G ocorreu somente na 8ª e 9ª semanas, coincidindo com a fase de preparação à parição. Houve aumento no perfil de α2 globulina entre a 2ª e 3ª semanas de gestação, porém tais valores não diferiram das fêmeas em diestro. Diferença significativa de α2 globulina foi observada apenas durante a 4ª, 5ª, 6ª, 8ª e 9ª semanas entre os dois grupos avaliados. As concentrações séricas de ß globulina nas cadelas não-gestantes foi superior às das fêmeas gestantes durante a 2ª, 4ª e 7ª semanas. Durante o primeiro terço da gestação (1ª a 3ª semana), foi observado queda dos valores de γ globulina, coincidente ao período pré implantacional e durante a formação dos sítios de implantação. Entre a 8ª e 9ª semanas de gestação, houve acréscimo significativo de γ globulina, possivelmente conseqüente ao aumento da produção de imunoglobulinas direcionadas à glândula mamária, como constituinte do colostro. Em conclusão, as proteínas alteram-se de forma evidente durante o período de gestação. Foi possível inferir diferenças nas funções biológicas das proteínas sanguíneas em cadelas gestantes e não gestantes. As proteínas determinadas estão envolvidas com o estímulo inflamatório durante a gestação, além dos mecanismos de regulação hormonal e preparação do organismo materno à lactação.(AU)

The study of the organic interaction and physiological adaptations during pregnancy is of utmost importance for clinical evaluation and diagnosis of pathological conditions of pregnant bitches. The aim of the present study was to compare the serum protein profile (total protein, albumin, a1, a2, b and g globulin) of pregnant and diestrous bitches. For this purpose, 40 healthy 2 to7-year-old Great Dane bitches were used. The bitches were allocated in two experimental groups: Non-pregnant group (NP; n=20) and pregnant group (P; n=20). From each female, blood was drawn weekly during 9 weeks, from the diestrous onset until the beginning of anestrus or parturition, respectively from NP and P groups. The concentration of total protein, albumin and a1, a2, b and g globulins were determined from serum samples. No statistical difference was found for total protein between 1st and 6th weeks of pregnancy or diestrus. In both groups, there was a progressive decline in total protein concentration. At the end of pregnancy (7th to 9th week), a significant increase in total protein was verified, suggesting an anabolic process. Albumin concentration decreased between the 1st and 9th week in both groups, however, more markedly in the P group (with significant difference between groups at 7th, 8th and 9th week). The levels of α1 globulin in pregnant bitches increased significantly from the 2nd week on. Statistical difference was observed between groups only at the 8th and 9th week, during which a preparatory phase for parturition occurs. A significant rise in α2 globulin was shown between the 2nd and 3rd week of gestation, however without difference from the NP group. There was significant difference for α2 globulin between groups at the 4th, 5th, 6th, 8th and 9th week. Serum concentration of b globulin in diestrous bitches was superior than pregnant bitches at the 2nd, 4th and 7th week. During early gestation (1st to 3rd week) there was a decrease in g globulin, simultaneously to the preimplantation period and formation of implantation sites. An increase in g globulin was shown between the 8th and 9th week in pregnant bitches, possibly due to the increase in immunoglobulin synthesis targeting the mammary gland to form the colostrum. In conclusion, markedly changes in protein profile occur during gestation. It was possible to state different biological function of blood proteins in pregnant and diestrous bitches. The determined proteins are enrolled in the inflammatory stimulus during gestation, as well as in the hormonal regulatory mechanisms and maternal preparatory process to lactation.(AU)