Surfactant therapy for pulmonary edema due to intratracheally injected bile acid

Intratracheally injected bile acid has been shown to produce severe pulmonary edema. We investigated the therapeutic effect of an exogenous surfactant for aspirated bile acid. Anesthetized rabbits were injected intratracheally with 1 ml/kg body weight of taurocholic acid, diluted to 0.6% with normal saline solution. After the injection of taurocholic acid, the PaO2 values decreased, the PaCO2 values increased, and abnormal shadows appeared in chest x-rays. After surfactant injection, the rabbits improved, but pulmonary edema recurred after one hour. After additional injection of the surfactant, the improved condition was sustained for 6 h. All animals in the untreated group died within 5 h and were shown to have severe pulmonary edema. Conversely, microscopic examination revealed no pulmonary edema in animals surviving 6 h after surfactant treatment. Thus, exogenous surfactant can prevent damage to the lung caused by intratracheally injected bile acid.