Effects of perfluorochemicals for intrapulmonary vancomycin administration and partial liquid ventilation in an animal model of meconium-injured lungs.

Background: Acute lung injury, such as meconium aspiration syndrome in neonates, may present with exacerbated ventilation and perfusion abnormalities. This can impair the efficacy of intravenous antibiotic therapy in treating pulmonary infection. Intrapulmonary administration via perfluorochemical as a vehicle may adequately deliver drugs, such as the poorly pulmonary-penetrative antibiotic vancomycin, to affect lung regions while maintaining gas exchange and non-toxic serum level.

Methods: Twelve newborn piglets were injured with intra-tracheally installed human meconium, and randomly grouped into intravenous group (intravenous injection with vancomycin 15 mg/kg, followed by conventional gas ventilation) or intrapulmonary group (intrapulmonary instilled with vancomycin 15 mg/kg and perfluorochemical emulsion, followed by partial liquid ventilation). Blood samples were obtained to check vancomycin serum concentrations (0-240 mins). Lung tissues were tested for vancomycin contents.

Results: Intrapulmonary group animals had significantly lower vancomycin serum levels than the intravenous group, but vancomycin contents (198.9 +/- 72.5 microg/g dry tissue) in lung tissues was significantly higher than in the intravenous group (134.9 +/- 39.1 microg/g dry tissue) (p < 0.05). Gas exchange and lung compliance in the intrapulmonary group were also significantly better than in the intravenous group.

Conclusions: Perfluorochemical is a good vehicle to deliver vancomycin and maintains gas exchange in severe meconium-injured lungs.