Dose-dependent effects of intrabronchially administered exogenous surfactant in a porcine model of lung contusion.

Abstract

Surfactant dysfunction contributes to acute respiratory failure following lung contusion. Our experimental study aimed to determine whether exogenous surfactant administration improves regional ventilation and gas exchange in a porcine model of lung contusion. Lung contusion was induced in pigs (n=21) using a custom forceps instrument. Animals were randomized into three equal groups. The two treated groups received Curosurf® intrabronchially (5 mg/kg or 10 mg/kg) 30 minutes post-contusion, while the third group served as a control. Vital signs, blood gases, and regional tidal volume distribution via electrical impedance tomography (primary outcome) were monitored for 6 hours. A sustained improvement in regional ventilation of the contused lung region, accompanied by more efficient ventilation, evidenced by a lower ventilatory ratio and PaCO2, was observed in the 10 mg/kg group. A trend toward improvement in systemic oxygenation (PaO2 at FiO2=1) was also noted in this group at later time points. The 5 mg/kg dose showed no significant effects. Early intrabronchial surfactant administration (10 mg/kg) was associated with improved regional ventilation and overall ventilation efficiency in the porcine lung contusion model. These findings suggest potential benefits for managing lung mechanics after severe chest trauma. (J Trauma Acute Care Surg. 2026;00: 000-000. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Surgery of Trauma.).