Budesonide added to modified porcine surfactant curosurf may additionally improve the lung functions in meconium aspiration syndrome

Severe meconium aspiration sy ndrome (MAS) in newborns is often treated by exogenous surfac tant. Because its efficacy is reduced by meconium-induced inflammation, glucocorticoid budesonide was added into surfac tant preparation Curosurf to enhance efficacy of the surfactant therapy in experimental model of MAS. Oxygen-ventilated rabbits were intratracheally given meconium (25 mg/ml, 4 ml/kg) to induce respiratory failure. Thirty minutes later, animals were treated by intratracheal budesonide (0.25 mg/kg) ; or surfactant lung lavage (10 ml/kg, 5 mg phospholipids/ml) repeated twice, followed by undiluted Curosurf (100 mg phospholipids/kg) ; or by the above mentioned surfactant treatment with the last surfactant dose fortified with budesonide (0.25 mg/kg) ; or were untreated. Animals were ventilated for additional 5 hours and respiratory parameters were measured regularly. After sacrificing animals, wet-dry lung weight ratio was evaluated and plasma levels of interleukins (IL)-1beta, -6, -8, and TNF-alpha were measured by ELISA method. Efficacy of the given therapies to enhance lung functions and to diminish lung edema formation and in flammation increased from budesonide-only and surf actant-only therapy to surfactant+budesonide therapy. Combined therapy improved gas exchange from 30 min of administration, and showed a longer- lasting effect than surfactant-only therapy. In conclusions, budesonide additionally improv ed the effects of exogenous surfactant in experimental MAS.