Pulmonary Tc-99m-Human Serum Albumin Clearance And Effects Of Surfactant Replacement After Lung Lavage In Rabbits

Objective: Pulmonary clearance of technetium-labeled human serum albumin was measured in order to investigate whether the surfactant layer is a rate-limiting factor for the permeability of the alveolar-capillary membrane for Tc-99m labeled albumin, Design: Prospective, randomized, controlled trial,Setting: Research laboratory,Subjects: Nineteen white New Zealand adult rabbits,Interventions: Three groups of rabbits were studied: group 1 animals received natural surfactant after lung lavage; group 2 animals underwent lung lavage only; and group 3 animals were not ravaged and served as an untreated, healthy control group, All animals were ventilated with high pressures,Measurements and Main Results: Tc-99m-labeled albumin was nebulized into the inspiratory line of the breathing circuit with an air jet nebulizer. The clearance measurements were then immediately started, Gamma camera images were obtained in 1-min frames for 120 mins and stored in a 64 x 64 image matrix in a computer,In group 1 animals, surfactant restored blood gases to near normal, and all animals except one had bi-exponential clearance curves, The half-life of the fast compartment was 35.9 +/- 6.4 mins, and the half-life of the slow compartment was 847.5 +/- 143.5 mins. All group 2 animals also had bi-exponential clearance curves of the tracer (the half lives of the fast and slow compartments were 14.6 +/- 6.7 and 459.8 +/- 167 mins, respectively). The half-lives of both the fast (p<.01) and slow (p<.01) components were significantly different between groups 1 and 2, Group 3 had a monoexponential half-life of 580 +/- 225 mins,Conclusions: The use of Tc-99m-human serum albumin as a tracer molecule is possible and feasible. The clearance of this tracer is, in part, determined by the integrity of the pulmonary surfactant system, as it is with Tc-99m-diethylenetriamine pentaacetate.