Investigation of histopathological and radiological effects of surfactant treatment in an experimental female rat model of lung contusion

Document Type : Original Article


1 Beyhekim State Hospital, Department of Emergency Medicine, Konya, Turkey

2 Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey

3 Süleyman Demirel University Faculty of Medicine, Department of Emergency Medicine, Isparta, Turkey


Objective(s): Pulmonary contusion (PC) is a clinical entity that often accompanies blunt traumas. We aimed to investigate the radiological and histopathological effects of surfactant treatment in an experimental rat model in which lung contusion was formed by blunt thoracic trauma.
Materials and Methods: 50 female Sprague-Dawley rats were used. Five groups were formed randomly. In groups 2, 4, and 5 lung contusion was made by the drop-weight method after anesthesia. Intratracheal surfactant was administered in the 4th hr in groups 3 and 4 and in the 24th hr in groups 4 and 5. All rats were sacrificed and their lungs removed at 48 hr after contusion. Alveolar edema, congestion, hemorrhage, destruction, leukocyte infiltration, immune staining were examined histopathologically.
Results: When the first thoracic CT scans were evaluated, we observed two rats with rib fractures and four rats with pneumothorax. 4 and 48 hr thoracic CT evaluation contusion and atelectasis showed no statistically significant decrease (P>0.05). After sacrifice of group 2, in macroscopic evaluation, there was a heterogeneous contusion and hemorrhagic appearance in the lungs of rats and less hemorrhagic appearance was observed in Groups 4 and 5 than in Group 2. In comparison of Immunohistopathological findings, surfactant treatment showed a statistically significant decrease in leukocyte infiltration scores (P=0.046). Immunohistopathologically, surfactant group had more staining but only statistically significant when compared to groups 4 and sham. (P=0.036).
Conclusion: Surfactant treatment may be of significant benefit in lung contusion secondary to blunt chest trauma, and further prospective evidence of its efficacy in such disorders is needed.


Main Subjects

1. Raghavendran K, Davidson BA, Helinski JD, Marschke CJ, Manderscheid P, Woytash JA, et al. A rat model for isolated bilateral lung contusion from blunt chest trauma. Anesth. Analg 2005;101:1482-1489.
2. Cohn SM, Zieg PM. Experimental pulmonary contusion: review of the literature and description of a new porcine model. J Trauma Acute Care Surg 1996;41:565-571.
3. Machado-Aranda D, Wang Z, Yu B, Suresh M, Notter RH, Raghavendran K. Increased phospholipase A2 and lyso-phosphatidylcholine levels are associated with surfactant dysfunction in lung contusion injury in mice. Surgery 2013;153:25-35.
4. Holm B, Notter R, Siegle J, Matalon S. Pulmonary physiological and surfactant changes during injury and recovery from hyperoxia. J Appl Physiol 1985;59:1402-1409.
5. Demirhan R, Onan B, Oz K, Halezeroglu S. Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interact Cardiovasc Thorac Surg 2009;9:450-453.
6. Sardesai S, Biniwale M, Wertheimer F, Garingo A, Ramanathan R. Evolution of surfactant therapy for respiratory distress syndrome: past, present, and future. Pediatr Res. 2017;81:240-248.
7. Gavelli G, Canini R, Bertaccini P, Battista G, Bnà C, Fattori R. Traumatic injuries: imaging of thoracic injuries. Eur Radiol 2002;12:1273-1294.
8. Zambelli V, Bellani G, Amigoni M, Grassi A, Scanziani M, Farina F, et al. The effects of exogenous surfactant treatment in a murine model of two-hit lung injury. Anesth Analg 2015;120:381-388.
9. Raghavendran K, Davidson BA, Knight PR, Wang Z, Helinski J, Chess PR, et al. Surfactant dysfunction in lung contusion with and without superimposed gastric aspiration in a rat model. Shock 2008;30:508-517.
10. Li B, Chai J, Hu Q, Zhang X, Zhang D, Ma L, et al. Effects of exogenous pulmonary surfactant on acute lung injury in rats with severe burn-blast combined injury. Zhonghua Yi Xue Za Zhi 2015;95:133-137.
11. Strohmaier W, Trupka A, Pfeiler C, Thurnher M, Khakpour Z, Gippner-Steppert C, et al. Bilateral lavage with diluted surfactant improves lung function after unilateral lung contusion in pigs. Crit Care Med 2005;33:2286-2293.
12. Türüt H, Ciralik H, Kilinc M, Ozbag D, Imrek SS. Effects of early administration of dexamethasone, N-acetylcysteine and aprotinin on inflammatory and oxidant–antioxidant status after lung contusion in rats. Injury 2009;40:521-527.
13. Nieman GF, Bredenberg CE. High surface tension pulmonary edema induced by detergent aerosol. J Appl Physiol 1985;58:129-136.
14. Zola EM, Gunkel JH, Chan RK, Lim MO, Knox I, Feldman BH et al. Comparison of three dosing procedures for administration of bovine surfactant to neonates with respiratory distress syndrome. J Pediatr 1993;122:453-459.
15. Abdel-Latif ME, Osborn DA. Pharyngeal instillation of surfactant before the first breath for prevention of morbidity
and mortality in preterm infants at risk of respiratory distress syndrome. Cochrane Database Syst Rev 2011;16:8311.