Hyperoncotic enhancement of fetal pulmonary growth after tracheal occlusion: an alveolar and capillary morphometric analysis

Shaun M. Kunisaki, Robert W. Chang, Steven Andreoli, Sara Lewicke, Snow Peña-Peterson, Russell W. Jennings, Dario O. Fauza

Research output: Contribution to journalArticle


Background/Purpose: Previous work has shown that intrapulmonary delivery of oncotic agents enhance overall lung growth after late gestational fetal tracheal occlusion (TO). This study was a post hoc analysis aimed at determining whether actual alveolar and capillary hyperplasias are maximized in this setting. Methods: Twenty-one near term fetal lambs were evenly divided into 4 groups: group I comprised sham-operated controls; group II had TO alone; and groups III and IV underwent TO and intratracheal infusion of equal amounts of either saline or 25% albumin, respectively. Approximately 2 weeks thereafter, their lungs were examined by detailed alveolar and capillary morphometry before birth. Statistical analysis included analysis of variance and the Bonferroni correction for multiple comparisons (P < .05). Results: Total alveolar and capillary numbers, as well as total alveolar surface area, were significantly higher in group IV and lower in group I compared with all other groups, with no differences between groups II and III. Alveolar capillary load was normal in all groups. Conclusions: Intrapulmonary delivery of concentrated albumin safely enhances short-term alveolar and capillary hyperplasia in a late gestational model of fetal TO. This therapeutic concept may allow for TO to be effective and predictable when performed late in gestation.

Original languageEnglish (US)
Pages (from-to)1214-1218
Number of pages5
JournalJournal of pediatric surgery
Issue number7
StatePublished - Jul 2006


  • Albumin
  • Congenital diaphragmatic hernia
  • Fetal lung liquid
  • Fetal surgery
  • Fetal tracheal occlusion
  • Fetus
  • Lung development
  • Lung morphometrics
  • Pulmonary hypoplasia

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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