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

J Pediatr Surg. 2006 Jul;41(7):1214-8. doi: 10.1016/j.jpedsurg.2006.03.001.


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.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Albumins / administration & dosage*
  • Animals
  • Capillaries / drug effects
  • Female
  • Fetal Development / drug effects
  • Fetal Diseases
  • Fetal Organ Maturity / drug effects
  • Hernia, Diaphragmatic / complications
  • Ligation
  • Lung / blood supply
  • Lung / drug effects*
  • Lung / physiopathology
  • Lung Diseases / congenital
  • Lung Diseases / prevention & control
  • Models, Animal
  • Pregnancy
  • Pulmonary Alveoli / drug effects*
  • Pulmonary Alveoli / physiopathology
  • Sheep
  • Trachea / surgery*


  • Albumins