Abstract: A method of treating a patient having edematous lungs includes: administering a first surface tension-lowering component to the patient via the airways and administering a second surface tension-lowering component to the patient via the vasculature. The combined and complementary treatments may lower or normalize alveolar surface tension with improved efficiency and on a faster timescale, thereby reducing patient injury and mortality (FIG. 1).

Abstract: In permeability lung edema, cardiogenic lung edema or neonatal respiratory distress, there is heterogeneous liquid distribution throughout the lungs. The excess alveolar liquid reduces gas exchange. Mechanical ventilation is used to improve gas exchange. In the presence of heterogeneous liquid distribution, there are surface tension-dependent stress concentrations in septa separating aerated from flooded alveoli. Mechanical ventilation, by inflating the lung above normal volumes, thus increasing surface tension above normal, exacerbates the stress concentrations and consequently injures, or exacerbates pre-existing injury of, the alveolar-capillary barrier. Any means of lowering surface tension should lessen ventilation injury of the lung. In the present invention, dilute exogenous surfactant solution or surfactant protein C solution interacts with albumin to lower surface tension, likely through effective promotion of surfactant lipid adsorption.

Abstract: In permeability lung edema, cardiogenic lung edema or neonatal respiratory distress, there is heterogeneous liquid distribution throughout the lungs. The excess alveolar liquid reduces gas exchange. Mechanical ventilation is used to improve gas exchange. In the presence of heterogeneous liquid distribution, there are surface tension-dependent stress concentrations in septa separating aerated from flooded alveoli. Mechanical ventilation, by inflating the lung above normal volumes, thus increasing surface tension above normal, exacerbates the stress concentrations and consequently injures, or exacerbates pre-existing injury of, the alveolar-capillary barrier. Any means of lowering surface tension should lessen ventilation injury of the lung. In the present invention, dilute exogenous surfactant solution or surfactant protein C solution interacts with albumin to lower surface tension, likely through effective promotion of surfactant lipid adsorption.

Abstract: Rhodamine dye is delivered to regions of a lung having heterogeneous alveolar flooding by alveolar liquid, thereby lowering the surface tension of the alveolar liquid so as to lessen ventilation injury directly and, by promoting equitable redistribution of the alveolar liquid among the alveoli of the lung, indirectly. The rhodamine dye is delivered with an albumin and/or an exogenous surfactant. Exemplary rhodamine dyes include sulforhodamine B and rhodamine WT.

Abstract: Methods are provided for protecting against ventilation-induced lung injury by promoting equitable liquid distribution in a lung with alveolar flooding, in which flooded and aerated alveoli are interspersed. Since ventilation injuriously over-expands aerated alveoli adjacent to flooded alveoli and a pressure barrier is responsible for trapping liquid in discrete alveoli, the present invention provides various means for overcoming the pressure barrier to, in turn, promote equitable redistribution of flooding liquid amongst alveoli, reduce the number of aerated alveoli located adjacent to flooded alveoli and reduce ventilation injury of the lung. These means of overcoming the pressure barrier include: (i) use of accelerated deflation during mechanical ventilation; and ii) high frequency (>50 Hz) vibration of the lung.

Abstract: In permeability lung edema, cardiogenic lung edema or neonatal respiratory distress, there is heterogeneous liquid distribution throughout the lungs. The excess alveolar liquid reduces gas exchange. Mechanical ventilation is used to improve gas exchange. In the presence of heterogeneous liquid distribution, there are surface tension-dependent stress concentrations in septa separating aerated from flooded alveoli. Mechanical ventilation, by inflating the lung above normal volumes, thus increasing surface tension above normal, exacerbates the stress concentrations and consequently injures, or exacerbates pre-existing injury of, the alveolar-capillary barrier. Any means of lowering surface tension should lessen ventilation injury of the lung. In the present invention, dilute exogenous surfactant solution or surfactant protein C solution interacts with albumin to lower surface tension, likely through effective promotion of surfactant lipid adsorption.

Abstract: Methods are provided for protecting against ventilation-induced lung injury both directly, by lowering surface tension, and indirectly, by promoting equitable liquid distribution in pulmonary alveolar edema, in which liquid- and air-filled alveoli are normally interspersed. Since a pressure barrier is responsible for trapping liquid in discrete edematous alveoli and the magnitude of the barrier is proportional to surface tension at the air-liquid interface, the present invention provides various methods for promoting equitable redistribution of edema liquid amongst alveoli to help protect the lung during ventilation, including: i) use of an additive that lowers surface tension; ii) use of active, accelerated deflation during mechanical ventilation; and iii) high frequency (>50 Hz) vibration of the lung.

Abstract: Rhodamine dye is delivered to regions of a lung having heterogeneous alveolar flooding by alveolar liquid, thereby lowering the surface tension of the alveolar liquid so as to lessen ventilation injury directly and, by promoting equitable redistribution of the alveolar liquid among the alveoli of the lung, indirectly. The rhodamine dye is delivered with an albumin and/or an exogenous surfactant. Exemplary rhodamine dyes include sulforhodamine B and rhodamine WT.