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Pediatr Res. 2016 Jul;80(1):92-100. doi: 10.1038/pr.2016.39. Epub 2016 Mar 8.

Intratracheal atomized surfactant provides similar outcomes as bolus surfactant in preterm lambs with respiratory distress syndrome.

Author information

1
Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano University, Milano, Italy.
2
Neonatal Research, Murdoch Childrens Research Institute, Melbourne, Australia.
3
Neonatology, The Royal Children's Hospital, Parkville, Australia.
4
Department of Paediatrics, University of Melbourne, Melbourne, Australia.
5
Research and Development Department, Chiesi Farmaceutici SpA, Parma, Italy.
6
Neonatal Intensive Care Unit, Fondazione MBBM, Monza, Italy.
7
NICU, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico-Università degli Studi di Milano.

Abstract

BACKGROUND:

Aerosolization of exogenous surfactant remains a challenge. This study is aimed to evaluate the efficacy of atomized poractant alfa (Curosurf) administered with a novel atomizer in preterm lambs with respiratory distress syndrome.

METHODS:

Twenty anaesthetized lambs, 127 ± 1 d gestational age, (mean ± SD) were instrumented before birth and randomized to receive either (i) positive pressure ventilation without surfactant (Control group), (ii) 200 mg/kg of bolus instilled surfactant (Bolus group) at 10 min of life or (iii) 200 mg/kg of atomized surfactant (Atomizer group) over 60 min from 10 min of life. All lambs were ventilated for 180 min with a standardized protocol. Lung mechanics, regional lung compliance (electrical impedance tomography), and carotid blood flow (CBF) were measured with arterial blood gas analysis.

RESULTS:

Dynamic compliance and oxygenation responses were similar in the Bolus and Atomizer groups, and both better than Control by 180 min (all P < 0.05; two-way ANOVA). Both surfactant groups demonstrated more homogeneous regional lung compliance throughout the study period. There were no differences in CBFConclusion:In a preterm lamb model, atomized surfactant resulted in similar gas exchange and mechanics as bolus administration. This study suggests evaluation of supraglottic atomization with this system when noninvasive support is warranted.

PMID:
26954481
DOI:
10.1038/pr.2016.39
[Indexed for MEDLINE]

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