Lung deposition of nebulized surfactant in newborn piglets: Nasal CPAP vs Nasal IPPV

Autor: Federico Bianco, Doris Cunha-Goncalves, Valeria Perez-de-Sa, Anders Nord, Xabi Murgia, Martin Schlun, Francesca Ricci, Rikard Linner, Fabrizio Salomone
Rok vydání: 2019
Předmět:
Pulmonary and Respiratory Medicine
Neonatal respiratory distress syndrome
Swine
medicine.medical_treatment
Context (language use)
Infant
Premature
Diseases
Nose
Pulmonary function testing
Intermittent Positive-Pressure Ventilation
03 medical and health sciences
Surface-Active Agents
0302 clinical medicine
030225 pediatrics
medicine
Animals
Continuous positive airway pressure
Respiratory system
Lung
Positive end-expiratory pressure
Phospholipids
Mechanical ventilation
Biological Products
Respiratory Distress Syndrome
Newborn
Continuous Positive Airway Pressure
business.industry
Nebulizers and Vaporizers
Pulmonary Surfactants
medicine.disease
Respiration
Artificial
030228 respiratory system
Animals
Newborn
Anesthesia
Pediatrics
Perinatology and Child Health
business
Respiratory minute volume
Infant
Premature
Zdroj: Pediatric pulmonologyREFERENCES. 55(2)
ISSN: 1099-0496
Popis: Background: Nasal continuous positive airway pressure support (nCPAP) is the standard of care for prematurely born infants at risk of neonatal respiratory distress syndrome (nRDS). However, nasal intermittent positive pressure ventilation (NIPPV) may be an alternative to nCPAP in babies requiring surfactant, and in conjunction with surfactant nebulization, it could theoretically reduce the need for invasive mechanical ventilation. We compared lung deposition of nebulized poractant in newborn piglets supported by nCPAP or NIPPV. Methods: Twenty-five sedated newborn piglets (1.2-2.2 kg) received either nCPAP (3 cmH2O, n = 12) or NIPPV (3 cmH2O positive end expiratory pressure+3 cmH2O inspiratory pressure, n = 13) via custom-made nasal prongs (FiO2 0.4, Servo-i ventilator). Piglets received 200 mg kg−1 of technetium-99m-surfactant mixture continuously nebulized with a customized eFlow-Neos investigational vibrating-membrane nebulizer system. Blood gases were taken immediately before, during, and after nebulization. The deposition was estimated by gamma scintigraphy. Results: Mean surfactant deposition in the lungs was 15.9 ± 11.9% [8.3, 23.5] (mean ± SD [95% CI]) in the nCPAP group and 21.6 ± 10% [15.6, 27.6] in the NIPPV group (P =.20). Respiratory rates were similar in both groups. Minute volume was 489 ± 203 [360, 617] in the nCPAP group and 780 ± 239 [636, 924] mL kg−1 min−1 in the NIPPV group (P =.009). Blood gases were comparable in both groups. Conclusion: Irrespective of the noninvasive ventilatory support mode used, relatively high lung deposition rates of surfactant were achieved with nebulization. The amounts of deposited surfactant might suffice to elicit a pulmonary function improvement in the context of nRDS. (Less)
Databáze: OpenAIRE
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