Positive end-expiratory pressure and surfactant administration mode influence function in ex-vivo premature sheep lungs.

Autor: Pasteka R; Department Life Science Engineering, Competence Centre Medical Engineering & Integrated Healthcare, University of Applied Sciences Technikum Wien, Vienna, Austria., Hufnagl L; Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria., Forjan M; Department Life Science Engineering, Competence Centre Medical Engineering & Integrated Healthcare, University of Applied Sciences Technikum Wien, Vienna, Austria., Berger A; Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria., Werther T; Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria., Wagner M; Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Medical University of Vienna, Vienna, Austria.
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2024 Apr; Vol. 113 (4), pp. 722-730. Date of Electronic Publication: 2023 Dec 27.
DOI: 10.1111/apa.17083
Abstrakt: Aim: Respiratory distress syndrome often necessitates endotracheal surfactant administration in extremely preterm infants. Our study aimed to explore a multi-modal simulation tool for investigating treatment strategies in ex vivo sheep lungs during spontaneous breathing.
Methods: An electromechanical lung simulator (xPULM) mimicking spontaneous breathing was coupled with a non-aerated premature sheep lung, replicating a premature respiratory system. Changes in tidal volume for different positive end-expiratory pressure (PEEP) levels prior to and after either bolus or nebulised surfactant administration were compared.
Results: In two preterm sheep lungs, we observed a progressive decline in tidal volume with increasing PEEP levels prior to surfactant delivery from 0.30 ± 0.01 mL at zero PEEP to 0.04 ± 0.01 mL at 15 cmH2O PEEP. Our measurements showed that both bolus (p < 0.05) and nebulised (p < 0.05) surfactant administration resulted in a significant increase in tidal volume, with no significant difference (p = 0.71) between the two methods.
Conclusion: The experimental setup demonstrated the feasibility of xPULM for investigating the effectiveness of different PEEP levels and modes of surfactant administration with respect to tidal volume in premature sheep lungs. The lack of adequate lung water resorption in our model warrants further investigations.
(© 2023 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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