TY - JOUR T1 - N-acetylcysteine potentiates surfactant therapy for experimental meconium aspiration syndrome JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P1798 AU - Jana Kopincova AU - Pavol Mikolka AU - Daniela Mokra AU - Andrea Calkovska Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P1798.abstract N2 - Meconium aspiration syndrome (MAS) is meconium-induced respiratory failure of newborns associated with activation of inflammatory and oxidative pathways. One of the most effective therapies for severe MAS is exogenous surfactant administration which improves respiratory functions but does not treat the inflammation. Oxidative process can lead to later surfactant inactivation; hence, surfactant combination with antioxidative agent may improve the benefit of therapy. Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone, N-acetylcysteine (NAC) alone or by their combination and ventilated for 5 hours. Blood samples were taken before meconium application and in intervals 15 and 30 min after meconium and 30 min, 1, 3 and 5 hours after the treatment for evaluating of oxidative damage, white blood cell (WBC) differential count, blood gasses, ventilatory parameters and final IL8 and IL1β levels. WBC differential was assessed also in bronchoalveolar lavage fluid. NAC alone had only mild therapeutic effect on MAS. However, the combination of NAC and surfactant facilitated quicker onset of therapeutic effect in ventilatory parameters (oxygenation index, PaO2/FiO2) compared to surfactant. The combination was the only treatment whose effect lasted out till the end of experiment and which prevented leukocyte migration into the lungs and oxidative damage. Moreover, NAC supressed cytokine formation and thus seems to be favourable agent for improving surfactant therapy in MAS.Supported by: VEGA 1/0291/12, APVV-0435-11. ER -